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General NPI Number Information
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NPI Number | 1184221178
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Entity Type | Individual
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Provider Name | AMANDA E JOHNSON MSN, PMHNP-BC
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Gender | Female
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Dates
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Enumeration Date | 10/03/2020
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Last Update Date | 02/21/2025
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Provider Practice Location Address
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Address Line | 339 EAST AVE STE 303
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City | ROCHESTER
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State | NY
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Zip | 14604-2615
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Country | US
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Telephone | 315-359-1787
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Fax | 585-434-2635
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Provider Business Mailing Address
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Address Line | 339 EAST AVE STE 303
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City | ROCHESTER
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State | NY
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Zip | 14604-2615
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Country | US
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Telephone | 585-434-2633
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Fax | 585-434-2635
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 163W00000X
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Taxonomy Name | Registered Nurse
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License Number | 724072
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number | 405842
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License Number State | NY
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