# CAROLYN JACKMAN GORDON

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- **Entity:** Individual
- **Status:** Active
- **Sole proprietor:** Yes

## Provider details

- **NPI number:** 1710711262
- **Gender:** F
- **Credential:** CRNP, PMHNP-BC

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | 5022591 | NC | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | AC006921 | MD | — |

## Other

- **Enumeration date:** 08/28/2024
- **Last updated:** 07/23/2026