Gomez, Tara A
Gomez, Tara A is an individual health care provider with primary practice located at 2300 E 30Th St Bldg D Ste 101 , Farmington NM 87401-8990. She recently has only one registered license in Nursing Service Providers / Orthopedic, which is considered as her primary health care specialty. Gomez, Tara A can be contacted via phone (505) 327-1400.Contact Information
Primary practice address
2300 E 30Th St Bldg D Ste 101
Farmington NM 87401-8990
Phone: (505) 327-1400
Fax: (505) 564-3202
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Nursing Service Providers / Orthopedic | 163WX0800X | R52863 | New Mexico |
Profile Details
| NPI number | 1245423110 |
|---|---|
| LBN Legal business name | Gomez, Tara A |
| Credentials | RN SFA |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 23rd, 2007 |
| Last updated | May 6th, 2008 - about 16 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1245423110 | NPPES |
| New Mexico | MEDICAID | 47522 | |
| New Mexico | Other | 00NM006H18 | |
| New Mexico | Other | 10034667 | |
| New Mexico | Other | R52863 |
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