Provider Demographics
NPI:1306497128
Name:DR DUNHAM INTEGRATIVE FAMILY HEALTH NP PLLC
Entity type:Organization
Organization Name:DR DUNHAM INTEGRATIVE FAMILY HEALTH NP PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AMANDA
Authorized Official - Middle Name:
Authorized Official - Last Name:DUNHAM
Authorized Official - Suffix:
Authorized Official - Credentials:DNP, FNP
Authorized Official - Phone:518-579-0012
Mailing Address - Street 1:35 UNITED DR STE 102
Mailing Address - Street 2:
Mailing Address - City:WEST BRIDGEWATER
Mailing Address - State:MA
Mailing Address - Zip Code:02379-1027
Mailing Address - Country:US
Mailing Address - Phone:508-238-8646
Mailing Address - Fax:
Practice Address - Street 1:963 ROUTE 146 STE 1
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3636
Practice Address - Country:US
Practice Address - Phone:518-579-0012
Practice Address - Fax:949-577-4231
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-09-23
Last Update Date:2020-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamilyGroup - Single Specialty