Provider Demographics
NPI:1790166304
Name:DOMINICI, DEBORAH RHEA (RN, IBCLC)
Entity Type:Individual
Prefix:MS
First Name:DEBORAH
Middle Name:RHEA
Last Name:DOMINICI
Suffix:
Gender:F
Credentials:RN, IBCLC
Other - Prefix:MS
Other - First Name:DEBORAH
Other - Middle Name:RHEA
Other - Last Name:REILLY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN, IBCLC
Mailing Address - Street 1:4976 KELA PL APT D
Mailing Address - Street 2:
Mailing Address - City:EWA BEACH
Mailing Address - State:HI
Mailing Address - Zip Code:96706-3121
Mailing Address - Country:US
Mailing Address - Phone:808-292-4232
Mailing Address - Fax:
Practice Address - Street 1:4976 KELA PL APT D
Practice Address - Street 2:
Practice Address - City:EWA BEACH
Practice Address - State:HI
Practice Address - Zip Code:96706-3121
Practice Address - Country:US
Practice Address - Phone:808-292-4232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-06-10
Last Update Date:2015-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
HIRN-42561163WL0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WL0100XNursing Service ProvidersRegistered NurseLactation Consultant