Individual
JILL RENEE GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NREMT-B
Contact information
Practice address
BLDG 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7400
(334) 255-7368
Mailing address
BLDG 301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7400
(334) 255-7368
Taxonomy
Speciality
Code
Description
License number
State
146N00000X
Basic Emergency Medical Technician
E3084504
TX
164W00000X
Licensed Practical Nurse
Primary
2-064909
AL
Other
Enumeration date
09/18/2013
Last updated
10/03/2013
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