Johnson, Amanda Jean

Johnson, Amanda Jean is an individual health care provider with primary practice located at 4621 Eastpark Blvd , Madison WI 53718-2000. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Medical. Physician Assistants & Advanced Practice Nursing Providers / Surgical is her primary health care specialty. Johnson, Amanda Jean can be contacted via phone (608) 915-0100.

Contact Information

Primary practice address
4621 Eastpark Blvd Madison WI 53718-2000
Phone: (608) 915-0100
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 2394 Wisconsin
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 2394-023 Wisconsin

Profile Details

NPI number 1679569024
LBN Legal business name Johnson, Amanda Jean
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Sep 21st, 2005
Last updated Jan 30th, 2026 - about 9 months 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 1679569024 NPPES
Wisconsin MEDICAID 1679569024
Wisconsin Other 60959

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