Provider Demographics
NPI:1508907494
Name:DUNLOP, AMY MORGAN
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:MORGAN
Last Name:DUNLOP
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1843 BARRINGTON DR
Mailing Address - Street 2:
Mailing Address - City:SUN PRAIRIE
Mailing Address - State:WI
Mailing Address - Zip Code:53590-3503
Mailing Address - Country:US
Mailing Address - Phone:608-318-0957
Mailing Address - Fax:
Practice Address - Street 1:1000 EDGEWOOD COLLEGE DR
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53711-1997
Practice Address - Country:US
Practice Address - Phone:608-663-3262
Practice Address - Fax:608-663-3394
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-12
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209003014363LP0200X
WI3024033363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics