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DOMINIQUE NETTLES

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
431 DALMAN AVE, FORT WAYNE, IN 46806-4011
(260) 312-9492
Mailing address
431 DALMAN AVE, FORT WAYNE, IN 46806-4011
(260) 312-9492

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
27072591A
IN

Other

Enumeration date
12/02/2024
Last updated
12/02/2024
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