Individual
MRS. NICOLE LYN DOMINICK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
1130 HIGHWAY 315 BLVD STE 4, WILKES BARRE, PA 18702-6952
(570) 823-8896
(570) 270-2692
Mailing address
1130 HIGHWAY 315 BLVD STE 4, WILKES BARRE, PA 18702-6952
(570) 823-8896
(570) 270-2692
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
SP018244
PA
Other
Enumeration date
12/04/2017
Last updated
12/20/2017
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