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Individual

CASSIDY GOMEZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DNP, RN, CRNA

Contact information

Practice address
700 S PARK ST, MADISON, WI 53715-1830
(608) 251-6100
(608) 258-5222
Mailing address
1121 E PLEASANT ST, MILWAUKEE, WI 53202-2124
(608) 515-6344

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
242630
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
145018
WI

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1841076882
WI
Enumeration date
09/06/2023
Last updated
11/09/2023
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