Provider Demographics
NPI:1699404731
Name:MCFARLANE, DOMINIQUA (LPN)
Entity Type:Individual
Prefix:MS
First Name:DOMINIQUA
Middle Name:
Last Name:MCFARLANE
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:15129 136TH AVE
Mailing Address - Street 2:
Mailing Address - City:JAMAICA
Mailing Address - State:NY
Mailing Address - Zip Code:11434-3513
Mailing Address - Country:US
Mailing Address - Phone:347-676-6626
Mailing Address - Fax:
Practice Address - Street 1:15129 136TH AVE
Practice Address - Street 2:
Practice Address - City:JAMAICA
Practice Address - State:NY
Practice Address - Zip Code:11434-3513
Practice Address - Country:US
Practice Address - Phone:347-676-6626
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-06-06
Last Update Date:2022-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY327147164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse