Individual
KRISTIN MARIE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
111 S 11TH ST, PHILADELPHIA, PA 19107-4824
(215) 955-6094
Mailing address
261 S 3RD ST, PHILADELPHIA, PA 19106-3912
(610) 331-8350
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
SP021610
PA
Other
Enumeration date
08/04/2017
Last updated
12/07/2020
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