Provider Demographics
NPI:1972783363
Name:GOMEZ, PATRICIA ANNE (RD LDN)
Entity Type:Individual
Prefix:MRS
First Name:PATRICIA
Middle Name:ANNE
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RD LDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:309 SANDCASTLE CIR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37069-7178
Mailing Address - Country:US
Mailing Address - Phone:615-476-5227
Mailing Address - Fax:
Practice Address - Street 1:309 SANDCASTLE CIR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37069-7178
Practice Address - Country:US
Practice Address - Phone:615-476-5227
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-11-14
Last Update Date:2017-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNLDN0000000805133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered