Individual
MADONNA K GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5000
Mailing address
1 MEDICAL CENTER DR, LEBANON, NH 03756-1000
(603) 650-5000
Taxonomy
Speciality
Code
Description
License number
State
363LP0200X
Pediatric Nurse Practitioner
Primary
061091-23
NH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
9649831
—
WA
Enumeration date
05/03/2007
Last updated
05/19/2017
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