Individual
KARISSA MARIE DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1111 HAYES AVE, SANDUSKY, OH 44870-3323
(419) 573-3504
Mailing address
242 WHITMAN BLVD, ELYRIA, OH 44035-1726
(440) 541-4130
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
XXXXXX
OH
Other
Enumeration date
05/24/2024
Last updated
05/24/2024
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