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1780037184
KELLEY EILEEN GOMEZ
BOISE, ID
NPI
1780037184
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Former Name
KELLEY EILEEN GROLL
Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363LF0000X Nurse Practitioner Family
(Licence: VT 101.0119709)
Enumeration Date
2016-07-20
Last Update Date
2018-12-11
Business Address
MRS. KELLEY EILEEN GOMEZ APRN
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 508-864-0937
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Mailing Address
MRS. KELLEY EILEEN GOMEZ APRN
500 W FORT ST
BOISE, ID 83702-4501
Phone number: 208-422-1000
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