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NPI Code Detail

MEDICARE: MR. MARCIAL COLE GOMEZ LPN

MEDICARE:  MR. MARCIAL COLE GOMEZ  LPN
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1164W00000XLicensed Practical Nurse25-52168-112KS

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
125-52168-112OTHERKSPRACTICAL NURSE

General Provider Information

NPI Number : 1851951321
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARCIAL COLE GOMEZ LPN
Provider Business Mailing Address
First Line : 50 E 13TH ST UNIT 812
Second Line :
City : KANSAS CITY
State : MO
Zip : 64106-2935
Country : US
Telephone Number : 816-287-2016
Fax Number :
Provider Business Practice Location Address
First Line : 50 E 13TH ST UNIT 812
Second Line :
City : KANSAS CITY
State : MO
Zip : 64106-2935
Country : US
Telephone Number : 816-287-2016
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2019
Last Update Date : 05/29/2025

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Directions to “ MR. MARCIAL COLE GOMEZ LPN” Practice Location

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