Individual
KATHERINE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
RN
Contact information
Practice address
301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7033
Mailing address
301 ANDREWS AVE, LYSTER ARMY HEALTH CLINIC, FORT RUCKER, AL 36362-5333
(334) 255-7033
Taxonomy
Speciality
Code
Description
License number
State
163WC0400X
Case Management Registered Nurse
Primary
1-096767
AL
163WC0400X
Case Management Registered Nurse
NURR28000
AK
163WC0400X
Case Management Registered Nurse
RN 75699
HI
Other
Enumeration date
01/10/2017
Last updated
01/10/2017
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