Provider Demographics
NPI:1780455816
Name:JOHNSON, AMAYA N
Entity type:Individual
Prefix:
First Name:AMAYA
Middle Name:N
Last Name:JOHNSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:AMAYA
Other - Middle Name:N
Other - Last Name:CHRISTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9017 N UNIVERSITY AVE APT 3206
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73114-4344
Mailing Address - Country:US
Mailing Address - Phone:405-446-6280
Mailing Address - Fax:
Practice Address - Street 1:9017 N UNIVERSITY AVE APT 3206
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73114-4344
Practice Address - Country:US
Practice Address - Phone:405-446-6280
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-09
Last Update Date:2024-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK201499163WL0100X
OK374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula
No163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant