Provider Demographics
NPI:1689040784
Name:DOMANSKI, NANCY S
Entity Type:Individual
Prefix:
First Name:NANCY
Middle Name:S
Last Name:DOMANSKI
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 1:4459 ARENDELL ST
Mailing Address - Street 2:STE 5
Mailing Address - City:MOREHEAD CITY
Mailing Address - State:NC
Mailing Address - Zip Code:28557-2795
Mailing Address - Country:US
Mailing Address - Phone:252-240-2496
Mailing Address - Fax:
Practice Address - Street 1:4459 ARENDELL ST STE 5
Practice Address - Street 2:
Practice Address - City:MOREHEAD CITY
Practice Address - State:NC
Practice Address - Zip Code:28557-2793
Practice Address - Country:US
Practice Address - Phone:252-240-2496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-08-12
Last Update Date:2015-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist