Individual
LAVINA GORDON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
STNA
Contact information
Practice address
608 DARROW RD #B, AKRON, OH 44305
(330) 389-0506
Mailing address
608 DARROW RD APT B, AKRON, OH 44305-2149
(330) 389-0506
Taxonomy
Speciality
Code
Description
License number
State
376K00000X
Nurse's Aide
Primary
400909610509
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3100530
—
OH
Enumeration date
07/18/2014
Last updated
07/18/2014
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