Individual
JENNY JEAN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNP
Contact information
Practice address
2330 THORNTON TAYLOR PKWY STE B, FAYETTEVILLE, TN 37334-3673
(931) 227-4984
(931) 227-4985
Mailing address
2330 THORNTON TAYLOR PKWY STE B, FAYETTEVILLE, TN 37334-3673
(931) 227-4984
(931) 227-4985
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
0000031101
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0000031101
APRN LICENSE
TN
01
—
0000148760
RN LICENSE
TN
01
—
1-104021
RN LICENSE
AL
Enumeration date
03/03/2022
Last updated
03/03/2022
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