Provider Demographics
NPI:1871585547
Name:DOMEN, RAMONA M (CRNA)
Entity type:Individual
Prefix:DR
First Name:RAMONA
Middle Name:M
Last Name:DOMEN
Suffix:
Gender:F
Credentials:CRNA
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Mailing Address - Street 1:184 JUAN M CRUZ DR
Mailing Address - Street 2:
Mailing Address - City:SANTA RITA
Mailing Address - State:GU
Mailing Address - Zip Code:96915-1743
Mailing Address - Country:US
Mailing Address - Phone:671-344-9386
Mailing Address - Fax:
Practice Address - Street 1:NAVAL HOSPITAL GUAM
Practice Address - Street 2:ANESTHESIA DEPT
Practice Address - City:FPO
Practice Address - State:AP
Practice Address - Zip Code:96538-0490
Practice Address - Country:US
Practice Address - Phone:671-344-9304
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-18
Last Update Date:2014-04-29
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
IL51740367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered