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Individual
MAKALA A GORDON
Active
Individual
MAKALA A GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
227921
TN
363L00000X
Nurse Practitioner
34974
TN
363LP0200X
Pediatric Nurse Practitioner
Primary
34974
TN
Other
Enumeration date
10/21/2021
Last updated
12/05/2024
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