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General NPI Number Information
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NPI Number | 1235456138
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Entity Type | Individual
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Provider Name | JAMIE DUNN
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Gender | Female
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Dates
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Enumeration Date | 05/01/2010
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Last Update Date | 10/22/2024
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Provider Practice Location Address
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Address Line | 1603 MAIN ST SW
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City | LOS LUNAS
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State | NM
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Zip | 87031-8766
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Country | US
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Telephone | 505-865-6100
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Fax | 505-866-5297
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Provider Business Mailing Address
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Address Line | 8801 HORIZON BLVD NE STE 360
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City | ALBUQUERQUE
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State | NM
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Zip | 87113-1563
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Country | US
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Telephone | 505-246-2622
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Fax | 505-715-5334
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | 637
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License Number State | NM
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