Individual
CHRISTINE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1902 S MORRISON BLVD, HAMMOND, LA 70403-5742
(985) 230-5800
(985) 230-5859
Mailing address
PO BOX 3087, HAMMOND, LA 70404-3087
(985) 230-1682
(985) 230-6652
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP08203
LA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2400983
—
LA
Enumeration date
04/21/2015
Last updated
12/08/2022
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