Individual
MS. BARBARA JEAN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
132 COLONIAL DR, TOWANDA, PA 18848-8107
(570) 265-6165
(570) 265-3616
Mailing address
1 GUTHRIE SQ, SAYRE, PA 18840-1625
(570) 888-5858
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
RN219067L
PA
363LA2200X
Adult Health Nurse Practitioner
Primary
UP003277C
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
500001498
RR MEDICARE PIN
PA
01
—
CC9269
RR MEDICARE GROUP
PA
01
—
GU039833
MEDICARE GROUP
PA
Enumeration date
03/22/2006
Last updated
03/12/2021
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