Amanda L Dickey, MPAS, PA-C
Physician Assistant in Salt Lake City, UT. Individual provider (NPI-1).
NPI number1982256236
StatusActive
Last updated in NPPESAug 28, 2022
Details
- NPI
- 1982256236
- Entity type
- Individual (NPI-1)
- Name
- Amanda L Dickey
- Credential
- MPAS, PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jul 16, 2019
- Certification date
- Aug 28, 2022
- Last updated
- Aug 28, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | 12118651-1206 | UT | Yes |
| 363AM0700X | Physician Assistant, Medical | 12118651-1206 | UT |
Other names
- Amanda Mayhew (Former Name)
Practice location
555 N Starcrest Dr Apt B33Salt Lake City, UT 84116-2485
Phone 801-867-6525
Mailing address
3665 S 8400 W Ste 101Magna, UT 84044-4907
Phone 801-250-9638
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