MEDICARE: AMANDA MICHELLE JOHNSON

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	104100000X	Social Worker

General Provider Information

NPI Number	:	1255121372
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMANDA MICHELLE JOHNSON

Provider Business Mailing Address
First Line	:	1701 JACKSON ST
Second Line	:
City	:	BEATRICE
State	:	NE
Zip	:	68310-2241
Country	:	US
Telephone Number	:	402-806-0631
Fax Number	:

Provider Business Practice Location Address
First Line	:	1701 JACKSON ST
Second Line	:
City	:	BEATRICE
State	:	NE
Zip	:	68310-2241
Country	:	US
Telephone Number	:	402-806-0631
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/12/2025
Last Update Date	:	05/12/2025

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Directions to “ AMANDA MICHELLE JOHNSON ” Practice Location

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