Individual
ELIZABETH GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
4800 MEXICO RD, SUITE 102, SAINT PETERS, MO 63376-1666
(636) 441-0067
(636) 441-1062
Mailing address
PO BOX 23340, SAINT LOUIS, MO 63156-3340
(636) 441-0067
(636) 441-1062
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
2014023979
MO
Other
Enumeration date
10/30/2014
Last updated
10/30/2014
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