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Contact Information

BLAKE K GOMEZ, CPNP-AC
2525 CHICAGO AVE
MINNEAPOLIS, MN55404-4518
 Phone: 612-813-7888
 Fax: 612-813-6361
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

363LP0200X 50 Nurse Practitioner
 

Pediatrics, Critical Care

363LP0222X 50 Nurse Practitioner
Indicates primary specialty

NPI Profile & details for BLAKE K GOMEZ · (Female)

NPI Number 1447723796
Status Active
Credentials CPNP-AC
Entity Individual
Enumeration date 01/09/2019
Last updated 05/26/2021 - About 5 years ago
Sole proprietor 1 No
Identifiers
  • IL License # 209018598
  • MN License # 8198
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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