Individual
LISA GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP
Contact information
Practice address
4296 MOCCASIN TRL, WOODSTOCK, GA 30189-4867
(042) 934-4286
Mailing address
4296 MOCCASIN TRL, WOODSTOCK, GA 30189-4867
(404) 293-4286
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN097624
GA
Other
Enumeration date
03/10/2015
Last updated
08/07/2019
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