Individual
MARY E GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
325E KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4531
(207) 873-5665
(207) 873-5545
Mailing address
325E KENNEDY MEMORIAL DR, WATERVILLE, ME 04901-4531
(207) 873-5665
(207) 873-5545
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R016730
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
040648
ANTHEM
ME
01
—
39369
HARVARD PILGRIM HEALTHCAR
ME
Enumeration date
09/30/2005
Last updated
11/28/2007
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