Individual
MS. DENISE ANN GOMOLAK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
107 E OAK AVE, FLAGSTAFF, AZ 86001-1818
(928) 913-8800
(928) 913-8801
Mailing address
1200 N BEAVER ST, FLAGSTAFF, AZ 86001-3118
(928) 213-6235
(928) 213-6292
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
510829
CA
363LF0000X
Family Nurse Practitioner
Primary
AP1123
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
910514
—
AZ
05
—
910514
—
CA
Enumeration date
08/31/2006
Last updated
03/07/2023
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