Johnson, Amanda-Grace

Johnson, Amanda-Grace is an sole proprietor health care provider with primary practice located at 1297 Boulder City Pkwy Ste A , Boulder City NV 89005-1854. She recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Registered Nurse, Physician Assistants & Advanced Practice Nursing Providers / Family. Physician Assistants & Advanced Practice Nursing Providers / Family is her primary health care specialty. Johnson, Amanda-Grace can be contacted via phone (702) 294-1919.

Contact Information

Primary practice address
1297 Boulder City Pkwy Ste A Boulder City NV 89005-1854
Phone: (702) 294-1919
Fax: (702) 294-0072
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Registered Nurse 163W00000X 816524 Nevada
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X 816524 Nevada

Profile Details

NPI number 1790385136
LBN Legal business name Johnson, Amanda-Grace
Credentials DNP
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 26th, 2020
Last updated Oct 18th, 2022 - about 3 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1790385136 NPPES
Nevada MEDICAID 1790385136
Nevada Other 816524

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