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NPI Code Detail

MEDICARE: AMANDA P SIFUENTES-SMITH PA-C

MEDICARE: AMANDA P SIFUENTES-SMITH PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantIA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1417779968
Entity Type Code : Individual
Provider Name (Legal Business Name) : AMANDA P SIFUENTES-SMITH PA-C
Provider Business Mailing Address
First Line : 2000 UNIVERSITY AVE
Second Line :
City : DUBUQUE
State : IA
Zip : 52001-5099
Country : US
Telephone Number : 563-589-3662
Fax Number :
Provider Business Practice Location Address
First Line : 250 MERCY DR
Second Line :
City : DUBUQUE
State : IA
Zip : 52001-7320
Country : US
Telephone Number : 563-589-9666
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 10/28/2024
Last Update Date : 02/06/2026

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Directions to “ AMANDA P SIFUENTES-SMITH PA-C” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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