Individual
KELLY MARIE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
13462 TAFT ST, BROOKSVILLE, FL 34613-6820
(352) 600-8822
(352) 600-8883
Mailing address
10220 YALE AVE, WEEKI WACHEE, FL 34613-8375
(352) 600-8822
(352) 600-8883
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
APRN11007511
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
11007511
FL
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
C-RXN.0103332-C-NP
CO
Other
Enumeration date
06/05/2020
Last updated
10/10/2025
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