Individual
DOMINIQUE D LEVEQUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CPNP, FNPC
Contact information
Practice address
2626 E 46TH ST, INDIANAPOLIS, IN 46205-2380
(317) 475-9066
Mailing address
8420 COOPER LN, ZIONSVILLE, IN 46077-9360
(317) 873-2626
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71002011A
IN
363LP0200X
Pediatric Nurse Practitioner
71002011A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200822670
—
IN
Enumeration date
01/15/2007
Last updated
01/04/2016
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