Domoracki, Jacob
Domoracki, Jacob is an individual health care provider with primary practice located at 232 W 25Th St , Erie PA 16544-0001. He recently has 2 registered licenses in different health care specialties including Nursing Service Providers / Critical Care Medicine, Physician Assistants & Advanced Practice Nursing Providers / Acute Care. Physician Assistants & Advanced Practice Nursing Providers / Acute Care is his primary health care specialty. Domoracki, Jacob can be contacted via phone (814) 452-5000.Contact Information
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Nursing Service Providers / Critical Care Medicine | 163WC0200X | RN670780 | Pennsylvania |
Physician Assistants & Advanced Practice Nursing Providers / Acute Care | 363LA2100X | SP028313 | Pennsylvania |
Profile Details
NPI number | 1245919448 |
---|---|
LBN Legal business name | Domoracki, Jacob |
Credentials | CRNP |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Jul 14th, 2023 |
Last updated | Nov 7th, 2023 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1245919448 | NPPES |
Pennsylvania | Other | RN670780 | REGISTERED NURSE LICENSE |
Pennsylvania | Other | SP028313 | REGISTERED NURSE LICENSE |
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