Individual
DR. AMY R GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
525 PORTLAND AVE, MINNEAPOLIS, MN 55415-1533
(612) 596-9643
(612) 596-9641
Mailing address
525 PORTLAND AVE, MINNEAPOLIS, MN 55415-1533
(612) 596-9643
(612) 596-9641
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R1830486
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
H400240648
—
MN
Enumeration date
08/23/2013
Last updated
04/10/2017
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