Individual
MORGAN RUTHANN DOMMISSE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2900 W OKLAHOMA AVE, MILWAUKEE, WI 53215-4330
(262) 388-7078
Mailing address
5459 SILVER LAKE DR, WEST BEND, WI 53095-8714
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
746423
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100249771
—
WI
Enumeration date
07/05/2022
Last updated
10/18/2023
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