Provider Demographics
NPI:1841997525
Name:JOHNS, AMANDA LORRAINE (CNM)
Entity type:Individual
Prefix:
First Name:AMANDA
Middle Name:LORRAINE
Last Name:JOHNS
Suffix:
Gender:
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2727 NELSON RD APT T208
Mailing Address - Street 2:
Mailing Address - City:LONGMONT
Mailing Address - State:CO
Mailing Address - Zip Code:80503-9358
Mailing Address - Country:US
Mailing Address - Phone:706-614-1553
Mailing Address - Fax:
Practice Address - Street 1:2727 NELSON RD APT T208
Practice Address - Street 2:
Practice Address - City:LONGMONT
Practice Address - State:CO
Practice Address - Zip Code:80503-9358
Practice Address - Country:US
Practice Address - Phone:706-614-1553
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-02-13
Last Update Date:2025-04-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COC-APN.0004205-C-CNM367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife