Provider Demographics
NPI:1245800770
Name:TROIAN, DOMANIQUE
Entity Type:Individual
Prefix:
First Name:DOMANIQUE
Middle Name:
Last Name:TROIAN
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 1:1000 E WILLIAM ST STE 120
Mailing Address - Street 2:
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89701-3116
Mailing Address - Country:US
Mailing Address - Phone:775-883-8840
Mailing Address - Fax:775-883-8820
Practice Address - Street 1:1000 E WILLIAM ST STE 120
Practice Address - Street 2:
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89701-3116
Practice Address - Country:US
Practice Address - Phone:775-883-8840
Practice Address - Fax:775-883-8820
Is Sole Proprietor?:No
Enumeration Date:2021-06-28
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant