Provider Demographics
NPI:1184670853
Name:DUMONT, AMY E (ARNP)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:E
Last Name:DUMONT
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:AMY
Other - Middle Name:
Other - Last Name:EGAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:178 FARMINGTON RD OFC
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:NH
Mailing Address - Zip Code:03867-4352
Mailing Address - Country:US
Mailing Address - Phone:036-332-1133
Mailing Address - Fax:
Practice Address - Street 1:178 FARMINGTON RD
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:NH
Practice Address - Zip Code:03867-4352
Practice Address - Country:US
Practice Address - Phone:036-332-1133
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-25
Last Update Date:2024-09-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECNP81401363LF0000X
NH042971-23363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ME1184670853Medicaid
MENP4188Medicare PIN
MEP90882Medicare UPIN
ME1184670853Medicaid
ME255530099Medicaid