Provider Demographics
NPI:1649232802
Name:DUNNAM, AIMEE THERESA (DNP, APRN, PMHNP-BC,)
Entity Type:Individual
Prefix:
First Name:AIMEE
Middle Name:THERESA
Last Name:DUNNAM
Suffix:
Gender:F
Credentials:DNP, APRN, PMHNP-BC,
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3180 S BUD LN
Mailing Address - Street 2:
Mailing Address - City:ROYSE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:75189-6207
Mailing Address - Country:US
Mailing Address - Phone:214-924-6043
Mailing Address - Fax:
Practice Address - Street 1:1312 W 6TH ST
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66044-2219
Practice Address - Country:US
Practice Address - Phone:785-841-7297
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-04-04
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP111643363LP0808X
TX689893363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal