MRS. AMANDA JOY DOMINIK


Address: 4411 Arden View Ct, Arden Hills, MN 55112-1944
Phone: 6513310827

MRS. AMANDA JOY DOMINIK (NPI# 1518587120) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1518587120
Entity Type Individual
Full Name MRS. AMANDA JOY DOMINIK
Credential CNP
Practice Address 4411 Arden View Ct
Arden Hills
MN 55112-1944
Practice Telephone 6513310827
Mailing Telephone 6513310827
Enumeration Date 2020-04-23
Last Update Date 2020-04-23
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 363LP0200X Nurse Practitioner
Specialization: Pediatrics
7377 MN Physician Assistants & Advanced Practice Nursing Providers

Office Location

Street Address 4411 ARDEN VIEW CT
City ARDEN HILLS
State MN
Zip Code 55112-1944

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1437619988 Marjean Diane Leary Registered Nurse 338 New Brighton Road, Apt, Suite, Bldg. (optional), New Brighton, MN 55112 2019-03-21
1558802728 Krishna Katira Student in an Organized Health Care Education/Training Program 2442 County Hwy 10, Mounds View, MN 55112 2017-03-20
1245781608 Evan Fredrick Lieberman Counselor 1900 Silver Lake Rd, Suite 110, New Brighton, MN 55112 2016-10-20
1093262065 Ryan Zinken Nurse Practitioner 1900 Silver Lake Road, Suite 110, New Brighton, MN 55112 2016-09-07
1447703228 Alison Glodek Social Worker 2543 17th St Nw, New Brighton, MN 55112 2016-07-28
1659728194 Ge Vang Sr. Driver 2160 County Road E West #205, 2160 County Road E West #205, New Brighton, MN 55112 2016-05-14
1114373578 Jessica Gapinski Specialist/Technologist 3900 Bethel Drive, Arden Hills, MN 55112 2016-05-04
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Taxonomy Information

Taxonomy Code 363LP0200X
Grouping Physician Assistants & Advanced Practice Nursing Providers
Classification Nurse Practitioner
Specialization Pediatrics

Taxonomy Definition

Definition to come...

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NPI Name Taxonomy Address Enumeration
1881245504 Hailey Prescott Nurse Practitioner 2450 Riverside Avenue Se, Minneapolis, Mn, MN 55454-1400 2019-09-24
1598317570 Elisabeth Palmquist Nurse Practitioner 12000 Elm Creek Blvd N Ste 250, Maple Grove, MN 55369-7164 2019-07-10
1538644562 Angela Ashton Nurse Practitioner 345 Smith Ave N Ste 404, Saint Paul, MN 55102-2346 2018-09-25
1558865295 Meghan Kerry Deyo Nurse Practitioner 1804 7th St W Ste 200, Saint Paul, MN 55116-2300 2018-03-19
1336642131 Caitlin Anna Lingbeck Nurse Practitioner 14001 Ridgedale Dr #100, Minnetonka, MN 55305-1781 2018-03-18
1740799246 Maya Bastian Nurse Practitioner 12220 Travois Rd, Eden Prairie, MN 55347-4241 2017-09-27
1821523028 Robin Marie Parker Nurse Practitioner 14135 Cedar Avenue South, Suite 100, Apple Valley, MN 55124 2017-04-25
1538691043 Jenifer Flegel Nurse Practitioner 963 Robert St S, West Saint Paul, MN 55118-1446 2017-04-03
1154796811 Megan Stark Nurse Practitioner 2805 Campus Dr Ste 235, Plymouth, MN 55441-2678 2015-12-07
1720407497 Halley Gail Sage Nurse Practitioner 2525 Chicago Ave S., Minneapolis, MN 55404 2014-04-10
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Competitor

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City ARDEN HILLS
Zip Code 55112

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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