Provider Demographics
NPI:1487089918
Name:GOMES, YENDI NANCY (NP-C)
Entity type:Individual
Prefix:
First Name:YENDI
Middle Name:NANCY
Last Name:GOMES
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:YENDI
Other - Middle Name:NANCY
Other - Last Name:BRIGHT-GOMES
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2019 ALCOVY SHOALS BLF
Mailing Address - Street 2:
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30045-2787
Mailing Address - Country:US
Mailing Address - Phone:404-789-8778
Mailing Address - Fax:
Practice Address - Street 1:1301 SIGMAN RD NE STE 200
Practice Address - Street 2:
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012-3819
Practice Address - Country:US
Practice Address - Phone:770-483-9330
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-09-03
Last Update Date:2019-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN146220363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health