DOMINIQUE KYSHAN AVERETTE — OIG Excluded Provider (GRANDVIEW, MO, 1128a1)
DOMINIQUE KYSHAN AVERETTE — OIG Excluded Provider (GRANDVIEW, MO, 1128a1) is one of 9,000 exclusions in the ExcludeCheck dataset. Key details — Name: DOMINIQUE KYSHAN AVERETTE; Type: Individual; Provider category: EMPLOYEE - PRIVATE S.
| Name | DOMINIQUE KYSHAN AVERETTE |
|---|---|
| Type | Individual |
| Provider category | EMPLOYEE - PRIVATE S |
| Specialty | PERSONAL CARE PROVID |
| City | GRANDVIEW |
| State | MO |
| ZIP | 64030 |
| Exclusion authority | 1128a1 |
| Exclusion reason | Conviction of program-related crimes |
| Exclusion date | 2024-04-18 |
| Source | HHS-OIG LEIE |
$1499/mo
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