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Individual

MRS. DESTINY RENEE GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
840 PINE ST STE 750, MACON, GA 31201-7528
(478) 633-1458
(478) 633-5025
Mailing address
840 PINE ST STE 750, MACON, GA 31201-7528
(478) 633-1458
(478) 633-5025

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
RN277979
GA

Other

Enumeration date
12/08/2023
Last updated
04/30/2024
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