Provider Demographics
NPI:1124370085
Name:GOMEZ, NATALIE R (APRN-NP)
Entity Type:Individual
Prefix:
First Name:NATALIE
Middle Name:R
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:APRN-NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14040 HOSPITAL ROAD
Mailing Address - Street 2:
Mailing Address - City:BOYS TOWN
Mailing Address - State:NE
Mailing Address - Zip Code:68010-4113
Mailing Address - Country:US
Mailing Address - Phone:531-355-6800
Mailing Address - Fax:
Practice Address - Street 1:14040 HOSPITAL ROAD
Practice Address - Street 2:
Practice Address - City:BOYS TOWN
Practice Address - State:NE
Practice Address - Zip Code:68010-4113
Practice Address - Country:US
Practice Address - Phone:531-355-6800
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-10-02
Last Update Date:2021-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE111388363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner