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NPI Profile for KATHY L DOMIANO in AVA, MO.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Primary Care |
363LP2300X | 50 | Nurse Practitioner |
| NPI Number | 1265627970 |
|
| Status | Active | |
| Credentials | FNP (Family Nurse Practitioner) | |
| Entity | Individual | |
| Enumeration date | 09/06/2007 | |
| Last updated | 03/06/2008 - About 18 years ago | |
| Sole proprietor 1 | No | |
| Identifiers |
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| Hospital affiliation(s) |
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KATHY L DOMIANO
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KATHY L DOMIANO, FNP