Individual
MS. CARRIE KALLENBACH GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
300 BRADFORD STREET, MAGUIRE CORRECTIONAL FACILITY, REDWOOD CITY, CA 94063
(650) 363-4241
Mailing address
300 BRADFORD AVENUE, MAGUIRE CORRECTIONAL FACILITY, REDWOOD CITY, CA 94063
(650) 363-4241
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
12246
CA
Other
Enumeration date
12/22/2011
Last updated
09/12/2013
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