Doctor Name: | JULIA GORDON |
NPI Number: | 1689784084 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | CRNP |
License Number: | 1-075175 |
Business Practice Address: | 5811 Jack Springs Rd Atmore, AL - 365025025 |
Business Phone Number: | 2513688630 |
Business Fax Number: | |
Mailing Address: | 5001 S Pineville Rd, WALNUT HILL |
State: | FL |
Postal Code: | 325681421 |
Phone Number: | 2513689136 |
Fax Number: | |
NPI Enumeration Date: | 08/30/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LF0000X |
License Number: | 1-075175 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Family |
Taxonomy Definition: |