Provider Demographics
NPI:1225652639
Name:GOMES, EMILY C (NP)
Entity Type:Individual
Prefix:
First Name:EMILY
Middle Name:C
Last Name:GOMES
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:58 CHOLE CT
Mailing Address - Street 2:
Mailing Address - City:BARNSTABLE
Mailing Address - State:MA
Mailing Address - Zip Code:02630-1409
Mailing Address - Country:US
Mailing Address - Phone:508-648-7434
Mailing Address - Fax:
Practice Address - Street 1:58 CHOLE CT
Practice Address - Street 2:
Practice Address - City:BARNSTABLE
Practice Address - State:MA
Practice Address - Zip Code:02630-1409
Practice Address - Country:US
Practice Address - Phone:508-648-7434
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-01
Last Update Date:2020-06-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN250743363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily