Provider Demographics
NPI:1124988712
Name:GOMEZ-MANNS, ELIZABETH ANN (MSN-ED, BSN, FNP-BC)
Entity type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:ANN
Last Name:GOMEZ-MANNS
Suffix:
Gender:F
Credentials:MSN-ED, BSN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:14726B CAREY ST
Mailing Address - Street 2:
Mailing Address - City:CEDAR LAKE
Mailing Address - State:IN
Mailing Address - Zip Code:46303-7203
Mailing Address - Country:US
Mailing Address - Phone:219-662-5700
Mailing Address - Fax:219-662-2569
Practice Address - Street 1:12800 MISSISSIPPI PKWY STE A200
Practice Address - Street 2:
Practice Address - City:CROWN POINT
Practice Address - State:IN
Practice Address - Zip Code:46307-6902
Practice Address - Country:US
Practice Address - Phone:219-662-5700
Practice Address - Fax:219-662-2569
Is Sole Proprietor?:No
Enumeration Date:2025-11-14
Last Update Date:2025-11-14
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28187743A363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care