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MARY DOMINE
NPI 1013626597
Specialist in Waite Park, MN

Active since November 23, 2022
423 GREAT OAK DR, WAITE PARK, MN 56387(218) 287-4338 Get Directions Write a Review

NPPES record last updated: November 23, 2022. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Mary Domine NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MARY DOMINE (NPI 1013626597) is an individual specialist in Waite Park, Minnesota and active in the NPI registry since November 2022.

NPPES Registry Identity

NPI1013626597
Entity TypeIndividualFemale
Primary Taxonomy174400000X
Provider Legal NameMARY DOMINE
Location Address423 GREAT OAK DRWaite Park, MN 56387-2507
Mailing Address1547 30th Ave SMoorhead, MN 56560-5149
Phone(218) 287-4338
Sole ProprietorNo
Enumeration DateNovember 23, 2022
NPPES CertifiedNovember 23, 2022
✔ NPI 1013626597 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpecialistOther Service Providers
Taxonomy Code174400000X
Definition
An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.
423 GREAT OAK DR, Waite Park, MN 56387
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Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

REBECCA NELSON
Specialist
423 GREAT OAK DR
WAITE PARK, MN 56387
Stearns County (320) 281-5305
ERIN SCHOBORG
Specialist
423 GREAT OAK DR
WAITE PARK, MN 56387
Stearns County (218) 287-4338
JENNIFER GERTEN
Specialist
423 GREAT OAK DR
WAITE PARK, MN 56387
Stearns County (218) 287-4338
BARRY WOLFF
Specialist
423 GREAT OAK DR
WAITE PARK, MN 56387
Stearns County (218) 287-4338
TAYLOR SPREEMAN
Specialist
423 GREAT OAK DR
WAITE PARK, MN 56387
Stearns County (320) 281-5305
KLOE PETTIT-SPERLING
Specialist
423 GREAT OAK DR
WAITE PARK, MN 56387
Stearns County (320) 281-5305
NICOLE HINES
Specialist
423 GREAT OAK DR
WAITE PARK, MN 56387
Stearns County (218) 287-4338
COLIA BYNUM
Specialist
423 GREAT OAK DR
WAITE PARK, MN 56387
Stearns County (320) 281-5305

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Mary Domine's NPI number?

The NPI number for Mary Domine is 1013626597. It was assigned to this individual provider in the NPPES registry on November 23, 2022.

Where is Mary Domine located?

Mary Domine practices at 423 Great Oak Dr, Waite Park, MN 56387. The listed phone number is (218) 287-4338.

What is Mary Domine's specialty?

The primary specialty registered for this NPI is Specialist with taxonomy code 174400000X.

When was this NPI record last updated?

The NPPES record for Mary Domine was last updated on November 23, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.