Individual
JAMIE GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
1200 MEMORIAL DR, DALTON, GA 30720-2529
(706) 259-4435
(706) 226-2283
Mailing address
1419 CHATTANOOGA AVE, SUITE 4, DALTON, GA 30720-2642
(706) 259-4435
(706) 226-2283
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN047297
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000487341B
—
GA
Enumeration date
10/02/2006
Last updated
04/23/2015
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