IndividualActive
Blake Gomez, CPNP-AC
NPI 1447723796 · Pediatric Nurse Practitioner · Minneapolis, MN
Provider details
- NPI number
- 1447723796
- Entity type
- Individual
- Primary specialty
- Pediatric Nurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers
- Credential
- CPNP-AC
- Sex
- Female
- Sole proprietor
- No
- License
- 209018598 (IL)
Practice location
2525 Chicago Ave
Minneapolis, MN 55404-4518
Phone: (612) 813-7888
Fax: (612) 813-6361
Mailing address
10860 Kingsborough Trl
Cottage Grove, MN 55016-4660
Registry dates
- Enumerated
- 2019-01-09
- Last updated
- 2021-05-26
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.