Amanda F Boone, LPN

Individual provider Active NPI Licensed Practical Nurse · Johnson City, TN

NPI 1487154019 · NPPES record last updated Feb 20, 2018

Key facts

NPI
1487154019
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
88888 (TN)
Practice address
219 Princeton Rd
Johnson City, TN 37601-2052
Phone
(423) 975-2200
NPI assigned
Feb 20, 2018
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)
No

State licenses

LicenseStateTypeSpecialty
88888TNMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 88888 TN Yes

Addresses

Primary practice location

219 Princeton Rd
Johnson City, TN 37601-2052

Mailing address

15810 Kingsport Hwy
Chuckey, TN 37641-3651
Phone (423) 525-2917

Other providers in Johnson City, TN

All providers in Johnson City, TN · Licensed Practical Nurse in Tennessee

Sources for this page

Verify at the official NPI Registry.