Most Relevant Information
Provider Data
| NPI Number: | 1003517921 |
| Provider Name: | DOMINIQUE MARIE FATICA |
| Entity Type: | Individual |
| Taxonomy Code: | 363LF0000X |
| Specialty: | Nurse Practitioner |
| License Number: | APRN.CNP.0033468 |
Most Important Dates
| Enumeration Date: | 03/16/2023 |
| Last Updated: | 03/16/2023 |
Provider Practice Location
11706 CLIFTON BLVD
LAKEWOOD
OH
441072018
Practice Location Phone/Fax
| Phone: | 8663892727 |
| Fax: |
Provider Mailing Location
11706 CLIFTON BLVD
LAKEWOOD
OH
441072018
Provider Mailing Phone/Fax
| Phone: | 8663892727 |
| Fax: |