Provider Demographics
NPI:1780195727
Name:DUNLAP, AMANDA KATHLEEN (NP-C)
Entity Type:Individual
Prefix:
First Name:AMANDA
Middle Name:KATHLEEN
Last Name:DUNLAP
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13001 ELMORE RD
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99516-2907
Mailing Address - Country:US
Mailing Address - Phone:907-903-8914
Mailing Address - Fax:
Practice Address - Street 1:3340 PROVIDENCE DR STE A-452
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99508-4691
Practice Address - Country:US
Practice Address - Phone:907-562-2120
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-10-17
Last Update Date:2017-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK126708208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics