Provider Demographics
NPI:1497409114
Name:DUNN ERICSSON, AMY NICOLE
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:NICOLE
Last Name:DUNN ERICSSON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3650 S SPRINGBREEZE WAY
Mailing Address - Street 2:
Mailing Address - City:HOMOSASSA
Mailing Address - State:FL
Mailing Address - Zip Code:34448-3385
Mailing Address - Country:US
Mailing Address - Phone:352-860-3805
Mailing Address - Fax:
Practice Address - Street 1:3515 W CHERUB CT
Practice Address - Street 2:
Practice Address - City:LECANTO
Practice Address - State:FL
Practice Address - Zip Code:34461-8395
Practice Address - Country:US
Practice Address - Phone:352-860-3805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-02-10
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171400000XOther Service ProvidersHealth & Wellness Coach