Provider Demographics
NPI:1730109737
Name:DUNN, JAMIE LYNN (PA-C)
Entity type:Individual
Prefix:
First Name:JAMIE
Middle Name:LYNN
Last Name:DUNN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:610 MEADE DR
Mailing Address - Street 2:
Mailing Address - City:CORAOPOLIS
Mailing Address - State:PA
Mailing Address - Zip Code:15108-9667
Mailing Address - Country:US
Mailing Address - Phone:724-518-1454
Mailing Address - Fax:
Practice Address - Street 1:111 HAZEL LN
Practice Address - Street 2:SUITE 100
Practice Address - City:SEWICKLEY
Practice Address - State:PA
Practice Address - Zip Code:15143-1253
Practice Address - Country:US
Practice Address - Phone:412-741-8862
Practice Address - Fax:412-741-2553
Is Sole Proprietor?:No
Enumeration Date:2006-07-20
Last Update Date:2007-11-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMA003039L363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAS95611Medicare UPIN
PA054405Medicare ID - Type Unspecified