Individual
NICKITA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
6323 TROTTER ST, PHILADELPHIA, PA 19111-5841
(215) 543-2876
Mailing address
6323 TROTTER ST, PHILADELPHIA, PA 19111-5841
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN309777
PA
Other
Enumeration date
06/29/2026
Last updated
06/29/2026
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