Provider Demographics
NPI:1811427008
Name:DUNN, AMANDA ELIZABETH (DNP, APRN-NP)
Entity type:Individual
Prefix:DR
First Name:AMANDA
Middle Name:ELIZABETH
Last Name:DUNN
Suffix:
Gender:F
Credentials:DNP, APRN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:609 TETON DR
Mailing Address - Street 2:
Mailing Address - City:FARMINGTON
Mailing Address - State:NM
Mailing Address - Zip Code:87401-9270
Mailing Address - Country:US
Mailing Address - Phone:575-791-3133
Mailing Address - Fax:
Practice Address - Street 1:735 W ANIMAS ST
Practice Address - Street 2:
Practice Address - City:FARMINGTON
Practice Address - State:NM
Practice Address - Zip Code:87401-5616
Practice Address - Country:US
Practice Address - Phone:505-564-6850
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-19
Last Update Date:2017-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCNP-03260363LA2200X, 364SX0200X, 363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No364SX0200XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistOncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM46926534Medicaid