Individual
MS. ELLA MAE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
N.P.
Contact information
Practice address
450 WEST STATE STREET, 4TH FLOOR, BOISE, ID 83720-0036
(208) 334-5616
(208) 332-7346
Mailing address
450 WEST STATE STREET, 4TH FLOOR, BOISE, ID 83720-0036
(208) 334-5616
(208) 332-7346
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
IDAHONP-99
ID
Other
Enumeration date
12/02/2011
Last updated
12/02/2011
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