Provider Demographics
NPI:1417318957
Name:DIONNE, AMBER E (PA-C)
Entity type:Individual
Prefix:
First Name:AMBER
Middle Name:E
Last Name:DIONNE
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 1:6700 FRANCE AVE S
Mailing Address - Street 2:SUITE 300
Mailing Address - City:EDINA
Mailing Address - State:MN
Mailing Address - Zip Code:55435-1902
Mailing Address - Country:US
Mailing Address - Phone:952-345-3000
Mailing Address - Fax:952-345-6789
Practice Address - Street 1:6700 FRANCE AVE S
Practice Address - Street 2:SUITE 300
Practice Address - City:EDINA
Practice Address - State:MN
Practice Address - Zip Code:55435-1902
Practice Address - Country:US
Practice Address - Phone:952-345-3000
Practice Address - Fax:952-345-6789
Is Sole Proprietor?:No
Enumeration Date:2016-03-11
Last Update Date:2017-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN11939363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant