Individual
MRS. JESSICA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
809 82ND PKWY, MYRTLE BEACH, SC 29572-4607
(843) 692-1000
Mailing address
265 BROOKVIEW CENTRE WAY STE 203, KNOXVILLE, TN 37919-4053
(865) 379-4846
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
29864
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/02/2023
Last updated
01/28/2025
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