Provider Demographics
NPI:1144849290
Name:GOMEZ, MARIA ESMERALDA (RN, MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:ESMERALDA
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:RN, MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 BRYAN ST W
Mailing Address - Street 2:
Mailing Address - City:DOUGLAS
Mailing Address - State:GA
Mailing Address - Zip Code:31533-4730
Mailing Address - Country:US
Mailing Address - Phone:912-389-4586
Mailing Address - Fax:
Practice Address - Street 1:1003 SHIRLEY AVE
Practice Address - Street 2:
Practice Address - City:DOUGLAS
Practice Address - State:GA
Practice Address - Zip Code:31533-2123
Practice Address - Country:US
Practice Address - Phone:912-389-4101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-04-09
Last Update Date:2022-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN183090163WP1700X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WP1700XNursing Service ProvidersRegistered NursePerinatal