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Individual

JULIA GORDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
5811 JACK SPRINGS RD, ATMORE, AL 36502-5025
(251) 368-8630
Mailing address
5001 S PINEVILLE RD, WALNUT HILL, FL 32568-1421
(251) 368-9136

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-075175
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1-075175
RN LICENSE NUMBER
AL
05
631900010
AL
Enumeration date
08/30/2006
Last updated
07/08/2007
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