Individual
THERESA GORDON
Active
Individual
THERESA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
D184804
IA
367500000X
Certified Registered Nurse Anesthetist
RN625521
PA
Other
Enumeration date
04/12/2011
Last updated
06/12/2025
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