Individual
MISS CHRISTINA MARIE GORDON
Active
Individual
MISS CHRISTINA MARIE GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
FNP-BC
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
041420283
IL
363LF0000X
Family Nurse Practitioner
Primary
209015429
IL
Other
Enumeration date
03/02/2017
Last updated
03/02/2017
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