Individual
DAWN JANNICE DOMENECH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
A-GNP-C
Contact information
Practice address
888 W 16TH ST, YUMA, AZ 85364-4542
(928) 550-7000
(928) 550-7006
Mailing address
2851 S AVENUE B, BUILDING 4, YUMA, AZ 85364-7726
(928) 376-0026
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
TAP8363
AZ
363LF0000X
Family Nurse Practitioner
Primary
AP8363
AZ
363LG0600X
Gerontology Nurse Practitioner
TAP8363
AZ
Other
Enumeration date
01/14/2016
Last updated
08/17/2022
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