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NPI Code Detail

MEDICARE: AUDRIE FAITH GOMEZ

MEDICARE: AUDRIE FAITH GOMEZ
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
1171M00000XCase Manager/Care Coordinator

General Provider Information

NPI Number : 1578307666
Entity Type Code : Individual
Provider Name (Legal Business Name) : AUDRIE FAITH GOMEZ
Provider Business Mailing Address
First Line : PO BOX 1392
Second Line :
City : NORFOLK
State : NE
Zip : 68702-1392
Country : US
Telephone Number : 402-371-0220
Fax Number : 402-644-4593
Provider Business Practice Location Address
First Line : 2718 13TH ST
Second Line :
City : COLUMBUS
State : NE
Zip : 68601-4917
Country : US
Telephone Number : 402-371-0220
Fax Number : 402-644-4593
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2024
Last Update Date : 10/08/2025

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Directions to “ AUDRIE FAITH GOMEZ ” Practice Location

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