Individual
DONNA GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ANP / FNP
Contact information
Practice address
887 CONGRESS ST, PORTLAND, ME 04102
(207) 774-2381
Mailing address
39 WALLACE AVE, SO. PORTLAND, ME 04106
(207) 761-0650
(207) 761-8198
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
RN32466
ME
363LA2200X
Adult Health Nurse Practitioner
Primary
R032466
ME
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
248130099
—
ME
05
—
30343056
—
NH
Enumeration date
10/02/2006
Last updated
05/02/2024
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