Individual
JOSEPH JOHN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
6401 FRANCE AVE S, EDINA, MN 55435-2104
(952) 924-5000
Mailing address
6401 FRANCE AVE S, EDINA, MN 55435-2104
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
88977
MN
390200000X
Student in an Organized Health Care Education/Training Program
R 181776-8
MN
Other
Enumeration date
11/06/2011
Last updated
04/27/2012
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