Provider Demographics
NPI:1134487754
Name:DOMSHER, ERIN DAWN
Entity Type:Individual
Prefix:
First Name:ERIN
Middle Name:DAWN
Last Name:DOMSHER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:771 CORPORATE DR
Mailing Address - Street 2:SUITE 605
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503-5405
Mailing Address - Country:US
Mailing Address - Phone:859-410-8550
Mailing Address - Fax:859-223-0642
Practice Address - Street 1:771 CORPORATE DR
Practice Address - Street 2:SUITE 605
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-5405
Practice Address - Country:US
Practice Address - Phone:859-410-8550
Practice Address - Fax:859-223-0642
Is Sole Proprietor?:Yes
Enumeration Date:2012-05-02
Last Update Date:2012-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZE0600XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherElectroneurodiagnostic
No174H00000XOther Service ProvidersHealth Educator