Individual
CAROLYN DOUGHTY GORDAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PNP
Contact information
Practice address
433 W MEADOWVIEW RD, GREENSBORO, NC 27406-4316
(336) 370-9091
(336) 370-4922
Mailing address
1046 E WENDOVER AVE, GREENSBORO, NC 27405-6712
(336) 272-1050
(336) 272-0155
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
300060
NC
363LP0200X
Pediatric Nurse Practitioner
300060
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ZN000012
—
NC
Enumeration date
09/01/2005
Last updated
02/28/2011
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