IndividualActive
Kathy Domiano, FNP
NPI 1265627970 · Primary Care Nurse Practitioner · Ava, MO
Provider details
- NPI number
- 1265627970
- Entity type
- Individual
- Primary specialty
- Primary Care Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- FNP
- Sex
- Female
- Sole proprietor
- No
- License
- 154500 (MO)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Practice location
504 Nw 10th Ave
Ava, MO 65608
Phone: (417) 683-4831
Fax: (417) 683-1602
Approximate (ZIP-level) locationGet directions
Mailing address
504 Nw 10th Ave
Ava, MO 65608
Registry dates
- Enumerated
- 2007-09-06
- Last updated
- 2008-03-06
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.