Individual
AMANDA K DOMINGUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
10 COMMONS ST, RUTLAND, VT 05701-4651
(802) 747-3359
(802) 786-5204
Mailing address
10 COMMONS ST, RUTLAND, VT 05701-4651
(802) 747-3359
(802) 786-5204
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
101.0134655
VT
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
09/11/2020
Last updated
09/28/2020
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