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Individual

MS. JENNIFER ANNE DOMVILLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CNP

Contact information

Practice address
2123 BARRINGTON MANOR DR APT 307, RALEIGH, NC 27612-3419
(740) 304-7505
(740) 304-7505
Mailing address
2123 BARRINGTON MANOR DR APT 307, RALEIGH, NC 27612-3419

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5005824
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
3016257
OH
Enumeration date
11/02/2009
Last updated
07/31/2025
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