Individual
AMY E GOMEZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
4321 FIR ST, EAST CHICAGO, IN 46312-3049
(219) 392-7005
Mailing address
11155 OHIO ST, CROWN POINT, IN 46307-8054
(219) 688-1643
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28198322A
IN
363LF0000X
Family Nurse Practitioner
Primary
71008535A
IN
Other
Enumeration date
09/05/2018
Last updated
11/23/2018
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