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

Primary practice address
232 W 25Th St Erie PA 16544-0001
Phone: (814) 452-5000
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #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 2 years ago

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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1245919448 NPPES
Pennsylvania Other RN670780 REGISTERED NURSE LICENSE
Pennsylvania Other SP028313 REGISTERED NURSE LICENSE

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