Provider Demographics
NPI:1437258092
Name:DAWES, AMIE (PA)
Entity Type:Individual
Prefix:
First Name:AMIE
Middle Name:
Last Name:DAWES
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1475
Mailing Address - Street 2:
Mailing Address - City:DES MOINES
Mailing Address - State:IA
Mailing Address - Zip Code:50305-1475
Mailing Address - Country:US
Mailing Address - Phone:515-643-6888
Mailing Address - Fax:515-643-6899
Practice Address - Street 1:5901 WESTOWN PKWY STE 225
Practice Address - Street 2:
Practice Address - City:WEST DES MOINES
Practice Address - State:IA
Practice Address - Zip Code:50266-8297
Practice Address - Country:US
Practice Address - Phone:515-643-6888
Practice Address - Fax:515-643-6899
Is Sole Proprietor?:No
Enumeration Date:2006-09-21
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001513363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA36778OtherWELLMARK
IA36778OtherWELLMARK
IAI12797Medicare ID - Type Unspecified