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Guillermo Gomez, NP
Family Nurse Practitioner in Forest Park, Georgia
NPI 1972508752

Guillermo Gomez is a Family Nurse Practitioner based in Ellenwood, GA and is specialized in Family. Guillermo Gomez practices in Forest Park, GA and has the professional credentials of NP. The NPI Number for Guillermo Gomez is 1972508752 and holds a License No. RN126015 NP (Georgia).

The current practice location address for Guillermo Gomez is 4146 Jonesboro Rd, Forest Park, GA and can be reached out via phone at 404-361-2469.

Location: 4146 Jonesboro Rd, Forest Park, GA, 30294-2854
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1972508752
Provider Name
Guillermo Gomez
Credential
NP
Provider Entity Type
Individual
Gender
Male
Address
4146 Jonesboro Rd, Forest Park, GA, 30294-2854
Phone Number
404-361-2469
Fax Number
Provider Enumeration Date
06/17/2005
Last Update Date
03/08/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
810457223B 05 GA
institution
Provider Business Practice Location Address Details
Address
4146 Jonesboro Rd
City
Forest Park
State
Georgia
Zip
30297-1038
Phone Number
404-361-2469
Fax Number
person
Provider Business Mailing Address Details
Address
4146 Jonesboro Rd
City
Forest Park
State
Georgia
Zip
30297-1038
Phone Number
404-361-2469
Fax Number
person
Provider's Taxonomy Details 1
Type
Physician Assistants & Advanced Practice Nursing Providers
Classification
Nurse Practitioner
Speciality
Family
Taxonomy
363LF0000X
License No.
RN126015 NP (Georgia)
Definition
Definition to come...
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