Individual
DONNA SUE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
8507 EMERALD HILL DR, AUSTIN, TX 78759-8012
(512) 343-5559
Mailing address
8507 EMERALD HILL DR, AUSTIN, TX 78759-8012
(512) 343-5559
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
508138
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
176175102
—
TX
01
—
85945U
BLUE CROSS BLUE SHIELD
TX
Enumeration date
06/03/2006
Last updated
07/12/2013
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