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Individual

MRS. NATALIE ADA DOMINGUEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
RN

Contact information

Practice address
HWY 160/163 BUILDING KA-2010, KAYENTA, AZ 86033-0368
(928) 697-4100
(928) 697-4029
Mailing address
PO BOX 368, HWY 160/163 BUILDING KA-2010, KAYENTA, AZ 86033-0368
(928) 697-4100
(928) 697-4029

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN175037
AZ
163WE0003X
Emergency Registered Nurse
RN175037
AZ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
060012
AZ
Enumeration date
01/15/2013
Last updated
01/26/2013
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