Provider Demographics
NPI:1972739894
Name:ELLIOTT, AMANDA COURTNEY (DO)
Entity Type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:COURTNEY
Last Name:ELLIOTT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:MS
Other - First Name:AMANDA
Other - Middle Name:COURTNEY
Other - Last Name:BLOUNT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:DEPARTMENT OF PSYCHIATRY - 1870 JPP
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-356-1188
Mailing Address - Fax:319-384-8843
Practice Address - Street 1:200 HAWKINS DR
Practice Address - Street 2:DEPARTMENT OF PSYCHIATRY - 1870 JPP
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52242-1009
Practice Address - Country:US
Practice Address - Phone:319-356-1188
Practice Address - Fax:319-384-8843
Is Sole Proprietor?:No
Enumeration Date:2009-06-05
Last Update Date:2014-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA43322084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent Psychiatry