Provider Demographics
NPI:1912781857
Name:GOMES, MEGAN MARIE (RN)
Entity Type:Individual
Prefix:
First Name:MEGAN
Middle Name:MARIE
Last Name:GOMES
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 1:41 BOWDOIN ST APT 26
Mailing Address - Street 2:
Mailing Address - City:WINTHROP
Mailing Address - State:MA
Mailing Address - Zip Code:02152-3148
Mailing Address - Country:US
Mailing Address - Phone:973-752-1342
Mailing Address - Fax:
Practice Address - Street 1:41 BOWDOIN ST APT 26
Practice Address - Street 2:
Practice Address - City:WINTHROP
Practice Address - State:MA
Practice Address - Zip Code:02152-3148
Practice Address - Country:US
Practice Address - Phone:974-752-1342
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-22
Last Update Date:2023-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2308483163WC0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WC0400XNursing Service ProvidersRegistered NurseCase Management