Individual provider · Type 1 NPI
Leticia Domingo, CRNP, RN
Adult Health Nurse Practitioner · Philadelphia, PA
NPI number
1275964835
Active
Practice location
3401 N Broad St
Philadelphia, PA 19140-5103
Fax (215) 707-8062
Mailing address
2450 W Hunting Park Ave
Philadelphia, PA 19129-1302
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Adult Health Nurse Practitioner Primary | 363LA2200X | TP005775C (PA) |
Adult Health Nurse Practitioner: Definition to come...
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About NPI 1275964835
Leticia Domingo, CRNP, RN's National Provider Identifier is 1275964835, issued on Dec 9, 2013. The primary taxonomy on file is Adult Health Nurse Practitioner (363LA2200X), and the practice location is in Philadelphia, PA. The record was last updated on May 11, 2017.