Individual provider · NPI-1

Dana Domanski-Mcnulty, FNP-C

Nurse Practitioner, Family · Southgate, MI

NPI number1760070635
StatusActive
Last updated in NPPESMay 9, 2022

Details

NPI
1760070635
Entity type
Individual (NPI-1)
Name
Dana Domanski-Mcnulty
Credential
FNP-C
Sex
Female
Sole proprietor
No
Enumeration date
Jan 6, 2021
Certification date
May 9, 2022
Last updated
May 9, 2022

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LF0000X Nurse Practitioner, Family4704270401MIYes

Practice location

15830 Fort St
Southgate, MI 48195-1367

Phone 734-282-5444

Mailing address

15830 Fort St
Southgate, MI 48195-1367

Phone 734-282-5444

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