Provider Demographics
NPI:1801588819
Name:GOMEZ, YAZMILIE (RN)
Entity type:Individual
Prefix:MS
First Name:YAZMILIE
Middle Name:
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:556 GRATTAN ST APT C
Mailing Address - Street 2:
Mailing Address - City:CHICOPEE
Mailing Address - State:MA
Mailing Address - Zip Code:01020-1586
Mailing Address - Country:US
Mailing Address - Phone:413-885-2555
Mailing Address - Fax:
Practice Address - Street 1:556 GRATTAN ST APT C
Practice Address - Street 2:
Practice Address - City:CHICOPEE
Practice Address - State:MA
Practice Address - Zip Code:01020-1586
Practice Address - Country:US
Practice Address - Phone:413-885-2555
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-26
Last Update Date:2023-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2310505163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse