Provider Demographics
NPI:1588067557
Name:DUPONT, AMY M (PA-C)
Entity type:Individual
Prefix:
First Name:AMY
Middle Name:M
Last Name:DUPONT
Suffix:
Gender:
Credentials:PA-C
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Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-384-0520
Mailing Address - Fax:319-384-0603
Practice Address - Street 1:701 W FOREVERGREEN RD
Practice Address - Street 2:
Practice Address - City:NORTH LIBERTY
Practice Address - State:IA
Practice Address - Zip Code:52317-9848
Practice Address - Country:US
Practice Address - Phone:319-384-6562
Practice Address - Fax:319-356-3949
Is Sole Proprietor?:No
Enumeration Date:2014-10-03
Last Update Date:2025-04-28
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IA121704363A00000X
MN11941363A00000X
WI3441-23363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant