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Provider Information for 1740748474

Please Note: Issuance of an NPI does not ensure or validate that the Health Care Provider is Licensed or Credentialed. For more information please refer to NPI: What You Need to Know

ALEXIS S GOMEZ PA-C

Gender: FEMALE

Individual NPI: 1740748474

Calendar   Last Updated:  2019-03-12
  Certification Date: 

Details

Name Value
NPI 1740748474
Enumeration Date 2019-03-12
NPI Type 1 - Individual
Sole Proprietor NO
Status Active
Mailing Address 1255 WESTPOINTE DR APT 4
GREENVILLE, NC 27834-8919
United States

Phone: 919-522-9379 | Fax:
View Map External Link
Primary Practice Address 257 NC-125
ROANOKE RAPIDS, NC 27870
United States

Phone: 252-410-0001 | Fax: 252-410-0003
View Map External Link
Health Information Exchange
Endpoint Type Endpoint Endpoint Description Use Content Type Affiliation Endpoint Location
Other Identifiers
Issuer State Number
Taxonomy
Primary Taxonomy Selected Taxonomy State License Number
Yes 363A00000X - Physician Assistant NC 0010-08800