Provider Demographics
NPI:1295160935
Name:JOHNSON, AMY E (DNP, FNP-C)
Entity type:Individual
Prefix:DR
First Name:AMY
Middle Name:E
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 633
Mailing Address - Street 2:
Mailing Address - City:BEDFORD
Mailing Address - State:VA
Mailing Address - Zip Code:24523-0633
Mailing Address - Country:US
Mailing Address - Phone:540-296-0534
Mailing Address - Fax:
Practice Address - Street 1:10102 LEESVILLE RD
Practice Address - Street 2:
Practice Address - City:LYNCH STATION
Practice Address - State:VA
Practice Address - Zip Code:24571-2210
Practice Address - Country:US
Practice Address - Phone:540-296-0534
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-12
Last Update Date:2013-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024171189363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily