Individual
CASEY DOMINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
363LP0200X
CO
363LP0200X
Pediatric Nurse Practitioner
95015310
CA
363LP0200X
Pediatric Nurse Practitioner
AP61457920
WA
Other
Enumeration date
10/21/2020
Last updated
08/07/2023
Update your record
If you believe information in your NPPES record is inaccurate, or if you wish to update or deactivate your NPI, you can do so directly with CMS at https://nppes.cms.hhs.gov.
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