Individual
MARIA KRISELDA GROSPE DOMINGO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MSN,APRN,NP-C
Contact information
Practice address
1536 FENMORE ST, LITHIA SPRINGS, GA 30122-6863
(678) 779-5765
Mailing address
1536 FENMORE ST, LITHIA SPRINGS, GA 30122-6863
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
NP264551
GA
363L00000X
Nurse Practitioner
NP95037093
CA
Other
Enumeration date
07/09/2025
Last updated
11/13/2025
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