John, Amanda Sue

John, Amanda Sue is an individual health care provider with primary practice located at 1320 W Main St , Newark OH 43055-1822. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered, which is considered as her primary health care specialty. John, Amanda Sue can be contacted via phone (220) 564-4226.

Contact Information

Primary practice address
1320 W Main St Newark OH 43055-1822
Phone: (220) 564-4226
Fax: (220) 564-4217
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Anesthetist, Certified Registered 367500000X COA-12359-NA Ohio

Profile Details

NPI number 1164409124
LBN Legal business name John, Amanda Sue
Credentials Certified Registered Nurse Anesthetist (CRNA)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 29th, 2005
Last updated Dec 9th, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1164409124 NPPES
Ohio MEDICAID 0053321

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