Doctor Name: | ANNE MARIE GORDON |
NPI Number: | 1285866681 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP |
License Number: | TMP139487 |
Business Practice Address: | 116 N Maple St Cherryvale, KS - 673351729 |
Business Phone Number: | 6203363255 |
Business Fax Number: | 6203363755 |
Mailing Address: | 116 N Maple St, CHERRYVALE |
State: | KS |
Postal Code: | 673351729 |
Phone Number: | 6203363255 |
Fax Number: | 6203363755 |
NPI Enumeration Date: | 08/18/2009 |
NPI Last Update Date: | 04/05/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | TMP139487 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | KS |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |