Individual
STEPHANIE JEAN DOMINGUEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
342 N WATER ST STE 600, MILWAUKEE, WI 53202-5715
(651) 342-1039
(651) 342-1428
Mailing address
270 MAIN ST N STE 300, STILLWATER, MN 55082-6788
(651) 342-1039
(651) 342-1428
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
2696-23
WI
Other
Enumeration date
12/02/2010
Last updated
05/04/2026
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