Provider Demographics
NPI:1114355823
Name:GOMES, NARINA ODESSA (CNA)
Entity type:Individual
Prefix:
First Name:NARINA
Middle Name:ODESSA
Last Name:GOMES
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3020I PROSPERITY CHURCH RD STE 630
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28269-8112
Mailing Address - Country:US
Mailing Address - Phone:704-598-6603
Mailing Address - Fax:
Practice Address - Street 1:8647 EARTHENWARE DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-7353
Practice Address - Country:US
Practice Address - Phone:704-618-0524
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-10-16
Last Update Date:2023-10-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC413145251E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health