Eunice Amanda Johnson, RN
Individual provider Active NPI Psychiatric/Mental Health Registered Nurse · Boardman, OR
NPI 1104545680 · NPPES record last updated Aug 26, 2022
Key facts
- NPI
- 1104545680
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Registered Nurse 163WP0808X
- License
- 201241643RN (OR)
- Practice address
- 70363 Kunze Lane
Boardman, OR 97818 - Phone
- (541) 481-3233
- Fax
- (541) 481-3234
- NPI assigned
- Aug 26, 2022
- Sex
- Female
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Registered Nurse
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Registered Nurse | 163WP0808X | 201241643RN | OR | Yes |
Addresses
Primary practice location
70363 Kunze Lane
Boardman, OR 97818
Mailing address
PO Box 469
Heppner, OR 97836-0469
Phone (541) 676-9161
Other providers in Boardman, OR
- Robert Doyle Hubbell
- Hollie Huff
- Hayley Cherie Huntington
- Maria Eva Jaime Ramos
- Meagen B Jenkins
- Brandon Manuel Juarez Garcia
- Ziyad Amir Kadir
- Brett Andrew Koss
- John Landreth
- Nicholas Landreth
All providers in Boardman, OR · Psychiatric/Mental Health Registered Nurse in Oregon
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Aug 26, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.