Individual
SAMANTHA SHYANNE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNA
Contact information
Practice address
227235 TEAL AVE, WAUSAU, WI 54401-2557
(630) 826-9753
Mailing address
16192 COASTAL HWY, LEWES, DE 19958-3608
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
09/19/2022
Last updated
09/19/2022
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