Provider Demographics
NPI:1609407477
Name:GOMES, VIOLET A (DNP, APRN, NP-C)
Entity type:Individual
Prefix:MRS
First Name:VIOLET
Middle Name:A
Last Name:GOMES
Suffix:
Gender:F
Credentials:DNP, APRN, NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:818 N 7TH ST
Mailing Address - Street 2:
Mailing Address - City:LEAVENWORTH
Mailing Address - State:KS
Mailing Address - Zip Code:66048-1422
Mailing Address - Country:US
Mailing Address - Phone:136-518-8609
Mailing Address - Fax:913-682-4409
Practice Address - Street 1:818 N 7TH ST
Practice Address - Street 2:
Practice Address - City:LEAVENWORTH
Practice Address - State:KS
Practice Address - Zip Code:66048-1422
Practice Address - Country:US
Practice Address - Phone:136-518-8609
Practice Address - Fax:913-682-4409
Is Sole Proprietor?:Yes
Enumeration Date:2020-01-30
Last Update Date:2024-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS79580363L00000X
KS108956163WP2201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No163WP2201XNursing Service ProvidersRegistered NurseAmbulatory Care
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS108956OtherKS STARE BOARD OF NURSING
KS79580OtherAPRN LICENSE