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General NPI Number Information
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NPI Number | 1255797528
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Entity Type | Individual
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Provider Name | DOMONIQUE KATONA PA-C
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Gender | Female
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Dates
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Enumeration Date | 01/02/2016
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Last Update Date | 08/27/2025
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Provider Practice Location Address
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Address Line | 4015 S BUFFALO DR STE 1
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City | LAS VEGAS
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State | NV
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Zip | 89147-7455
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Country | US
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Telephone | 725-293-4602
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Fax | 725-293-5351
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Provider Business Mailing Address
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Address Line | 102 WOODMONT BLVD STE 600
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City | NASHVILLE
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State | TN
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Zip | 37205-5250
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Country | US
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Telephone | 615-706-8357
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Fax | 615-523-1910
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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 | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA1693
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License Number State | NV
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Taxonomy #2
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | PA6844
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License Number State | MA
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