Individual
MRS. KELLY LYNN GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
SLP
Contact information
Practice address
40 DUKE MEDICINE CIR, CLINIC 1I, DURHAM, NC 27710-4000
(919) 684-3451
Mailing address
PO BOX 3887, BLDG. # 600, DURHAM, NC 27710-0001
(919) 684-6271
Taxonomy
Speciality
Code
Description
License number
State
235Z00000X
Speech-Language Pathologist
Primary
6510
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1443P
BLUE CROSS
NC
05
—
7412614
—
NC
Enumeration date
03/05/2007
Last updated
04/17/2015
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