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General NPI Number Information
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NPI Number | 1881553253
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Entity Type | Individual
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Provider Name | AMANDA C. JOHN APRN-FNP
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Gender | Female
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Dates
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Enumeration Date | 01/20/2026
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Last Update Date | 01/20/2026
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Provider Practice Location Address
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Address Line | 115 S RANDOLPH ST STE 101
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City | SAN ANGELO
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State | TX
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Zip | 76903-6425
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Country | US
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Telephone | 323-252-3403
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Fax |
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Provider Business Mailing Address
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Address Line | 415 CLOVER DR
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City | SAN ANGELO
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State | TX
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Zip | 76903-1104
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Country | US
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Telephone | 323-252-3403
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Fax |
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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 | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 1224745
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License Number State | TX
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