1144037326 NPI number — MRS. AMANDA EVALEE JOHNS RN

Table of content: MRS. AMANDA EVALEE JOHNS RN (NPI 1144037326)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1144037326 NPI number — MRS. AMANDA EVALEE JOHNS RN

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
JOHNS
Provider First Name:
AMANDA
Provider Middle Name:
EVALEE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
RN
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
URLING
Provider Other First Name:
AMANDA
Provider Other Middle Name:
EVALEE
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1144037326
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
12/12/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
972 CROOKED RIVER DR
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79932-1658
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-803-5638
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
18511 HIGHLANDER MEDICS ST
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FORT BLISS
Provider Business Practice Location Address State Name:
TX
Provider Business Practice Location Address Postal Code:
79906-5327
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
915-742-3424
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
12/12/2024

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  972869 , registered in the state of TX ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)