Provider Demographics
NPI:1225848633
Name:GOMEZ, YVETTE FERRALES
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:FERRALES
Last Name:GOMEZ
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:318 PACKETT DR
Mailing Address - Street 2:
Mailing Address - City:CHARLES TOWN
Mailing Address - State:WV
Mailing Address - Zip Code:25414-5266
Mailing Address - Country:US
Mailing Address - Phone:575-635-7028
Mailing Address - Fax:
Practice Address - Street 1:318 PACKETT DR
Practice Address - Street 2:
Practice Address - City:CHARLES TOWN
Practice Address - State:WV
Practice Address - Zip Code:25414-5266
Practice Address - Country:US
Practice Address - Phone:575-635-7028
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-08
Last Update Date:2025-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant