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Individual

ANNETTE GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
R.N. CLC

Contact information

Practice address
5559 REDWOOD DR, WILLOUGHBY, OH 44094-3222
(216) 712-0798
Mailing address
5559 REDWOOD DR, WILLOUGHBY, OH 44094-3222
(216) 712-0798

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN.240968
OH
163WC0400X
Case Management Registered Nurse
RN.240968
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
RP820172
DL
OH
Enumeration date
05/31/2011
Last updated
08/04/2022
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