Healthcare Provider Details

I. General information

NPI: 1003517921
Provider Name (Legal Business Name): DOMINIQUE MARIE LAPUH APRN-CNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: DOMINIQUE MARIE FATICA APRN-CNP

II. Dates (important events)

Enumeration Date: 03/16/2023
Last Update Date: 02/23/2026
Certification Date: 02/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

29800 BAINBRIDGE RD
SOLON OH
44139-2202
US

IV. Provider business mailing address

29800 BAINBRIDGE RD
SOLON OH
44139-2202
US

V. Phone/Fax

Practice location:
  • Phone: 440-519-6800
  • Fax:
Mailing address:
  • Phone: 440-519-6800
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.0033468
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: