Individual
WHITNEY MESHELL DOMANGUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
1001 GAUSE BLVD, SLIDELL, LA 70458-2987
(985) 280-2200
Mailing address
13232 VILLAGE TRACE DR, FOLSOM, LA 70437-6145
(870) 415-7896
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
337629
LA
Other
Enumeration date
08/14/2023
Last updated
10/24/2024
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