Individual
MRS. AMANDA LYNNE DOMINGUEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RN,CWOCN
Contact information
Practice address
5164 STRAUB RD, COLLEGE STATION, TX 77845-6952
(979) 676-2154
Mailing address
5164 STRAUB RD, COLLEGE STATION, TX 77845-6952
(979) 676-2154
Taxonomy
Speciality
Code
Description
License number
State
163WC2100X
Continence Care Registered Nurse
791866
TX
163WE0900X
Enterostomal Therapy Registered Nurse
791866
TX
163WW0000X
Wound Care Registered Nurse
791866
TX
163WX1500X
Ostomy Care Registered Nurse
Primary
791866
TX
Other
Enumeration date
09/04/2024
Last updated
09/04/2024
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