Individual
DYSTINE TYCHENA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
823 N ELM ST, GREENSBORO, NC 27401
(336) 900-1555
Mailing address
822 RUGBY ST, 822, GREENSBORO, NC 27406
(336) 988-9873
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
ON-9311-V387
NC
Other
Enumeration date
09/25/2025
Last updated
09/25/2025
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