Healthcare Provider Details

I. General information

NPI: 1053619783
Provider Name (Legal Business Name): AMANDA JOHNSON POTTER PHARMD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: AMANDA ERIN JOHNSON PHARMD

II. Dates (important events)

Enumeration Date: 03/03/2011
Last Update Date: 05/15/2026
Certification Date: 05/15/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

702 WINFIELD DUNN PKWY
SEVIERVILLE TN
37876-5511
US

IV. Provider business mailing address

702 WINFIELD DUNN PKWY
SEVIERVILLE TN
37876-5511
US

V. Phone/Fax

Practice location:
  • Phone: 865-429-1451
  • Fax: 865-429-3407
Mailing address:
  • Phone: 865-429-1451
  • Fax: 865-429-3407

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License Number40741
License Number StateTN
# 2
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number40741
License Number StateTN
# 3
Primary TaxonomyN
Taxonomy Code183500000X
TaxonomyPharmacist
License Number21594
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: