Healthcare Provider Details

I. General information

NPI: 1043090715
Provider Name (Legal Business Name): FRANCESCA DOMINGUEZ CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: FRANCESCA FALQUEZA

II. Dates (important events)

Enumeration Date: 10/02/2023
Last Update Date: 10/02/2023
Certification Date: 10/01/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7250 PARKWAY DR STE 500
HANOVER MD
21076-1343
US

IV. Provider business mailing address

12010 LITTLE PATUXENT PKWY APT O
COLUMBIA MD
21044-4814
US

V. Phone/Fax

Practice location:
  • Phone: 443-949-0814
  • Fax:
Mailing address:
  • Phone: 956-222-0933
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberR263151
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: