Individual
KATELYN GOMEZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
R.N.
Contact information
Practice address
6613 W FAIRVIEW AVE, MILWAUKEE, WI 53213-3934
(651) 491-9745
Mailing address
6613 W FAIRVIEW AVE, MILWAUKEE, WI 53213-3934
(651) 491-9745
Taxonomy
Speciality
Code
Description
License number
State
376G00000X
Nursing Home Administrator
Primary
168813
WI
Other
Enumeration date
09/30/2015
Last updated
09/30/2015
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