Individual
MARVIS GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
819 N 108TH ST, OMAHA, NE 68154-1705
(678) 633-7040
Mailing address
819 N 108TH ST, OMAHA, NE 68154-1705
(678) 633-7040
Taxonomy
Speciality
Code
Description
License number
State
374U00000X
Home Health Aide
Primary
—
—
Other
Enumeration date
06/30/2025
Last updated
06/30/2025
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