Individual
CARRIE JEAN GORDON-STACEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CNM
Contact information
Practice address
2231 BURDETT AVE STE 160, TROY, NY 12180-2453
(518) 326-1620
Mailing address
PO BOX 14890, ALBANY, NY 12212-4890
(518) 525-5634
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
Primary
001506
NY
367A00000X
Advanced Practice Midwife
FOO1506-1
NY
Other
Enumeration date
02/14/2013
Last updated
09/15/2021
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