Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jenna Mae Domino, APNP

Individual provider Registered Nurse · NPI 1780174664

Jenna Mae Domino, APNP is a Nurse Practitioner in Manitowoc, Wisconsin. Qualified in 2018, 8 years ago. Practices with Froedtert Manitowoc Medical Group, LLC, a 157-clinician group and accepts Medicare assignment. Licensed in Wisconsin.

Years since qualifying
8
Licensed in
WI
In the registry since
2018
Specialties on file
2
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Practice location Address checks out

2300 Western Ave
Manitowoc, WI 54220
Phone: (920) 320-3512
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 8540-33 (WI)
Registered Nurse Taxonomy 163W00000X · Licence 218918-30 (WI)

Record details

NPI number1780174664
Entity typeIndividual (Type 1)
GenderFemale
Credentials APNP
Sole proprietorNo
NPI enumeratedMay 16, 2018
Last updated in NPPESJanuary 23, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Froedtert Manitowoc Medical Group, Llc — 157 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

Other providers in Manitowoc