Healthcare Provider Details

I. General information

NPI: 1053221382
Provider Name (Legal Business Name): AMY HENRY JOHNSON RNC-OB
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/09/2026
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 WATSON BLVD
WARNER ROBINS GA
31093-3431
US

IV. Provider business mailing address

1601 WATSON BLVD
WARNER ROBINS GA
31093-3431
US

V. Phone/Fax

Practice location:
  • Phone: 478-542-7790
  • Fax:
Mailing address:
  • Phone: 478-542-7790
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WM0102X
TaxonomyMaternal Newborn Registered Nurse
License NumberRN124351
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: