Individual
MS. LAFAYE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7100 W HAMPTON AVE, APT 1, MILWAUKEE, WI 53218-4858
(414) 535-0811
(414) 535-1915
Mailing address
7100 W HAMPTON AVE, APT 1, MILWAUKEE, WI 53218-4858
(414) 535-0811
(414) 535-1915
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311989-031
WI
Other
Enumeration date
05/24/2010
Last updated
05/24/2010
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