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General NPI Number Information
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NPI Number | 1124103965
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Entity Type | Individual
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Provider Name | DOMINIQUE PINILLA FNP-C
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Gender | Female
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Dates
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Enumeration Date | 10/26/2006
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Last Update Date | 10/24/2024
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Provider Practice Location Address
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Address Line | 3720 DAVINCI CT STE 400
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City | NORCROSS
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State | GA
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Zip | 30092-7625
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Country | US
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Telephone | 706-582-4462
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Fax |
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Provider Business Mailing Address
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Address Line | 408 JOY SPRINGS CT
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City | GROVETOWN
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State | GA
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Zip | 30813-0288
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Country | US
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Telephone | 423-943-0856
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4704375947
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 1016285
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 215869
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License Number State | LA
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Taxonomy #4
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | APRN9450731
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License Number State | FL
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Taxonomy #5
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 5013683
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License Number State | NC
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Taxonomy #6
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 810603
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License Number State | MS
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Taxonomy #7
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | A173673
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License Number State | IA
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Taxonomy #8
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 2833
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License Number State | SC
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Taxonomy #9
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 4005394
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License Number State | KY
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Taxonomy #10
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 117974
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License Number State | WV
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Taxonomy #11
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 3-000363
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License Number State | AL
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Taxonomy #12
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | SP022300
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License Number State | PA
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Taxonomy #13
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | AP5358
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License Number State | AZ
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Taxonomy #14
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN253292
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License Number State | GA
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