LISA M. DEDOMENICO

KINGSTON, PA
NPI1184657751
Entity TypeIndividual
GenderFemale
Sole Proprietor ?No
Primary Taxonomy363L00000X Nurse Practitioner
(Licence: PA  TP001029G)
Additional Taxonomies363LX0001X Nurse Practitioner, Obstetrics & Gynecology
(Licence: PA  TP001029G)
Enumeration Date2006-07-08
Last Update Date2020-07-30
Business Address
LISA M. DEDOMENICO CRNP, MSN
190 WELLES ST
KINGSTON, PA 18704-4968
Phone number: 570-714-1099
Mailing Address
LISA M. DEDOMENICO CRNP, MSN
100 N ACADEMY AVE
DANVILLE, PA 17822-4903
Phone number: 570-271-6144