Individual
TIFFANY DAWN GORDON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
625 S 4TH ST STE A, LE SUEUR, MN 56058-2203
(507) 593-5920
Mailing address
258 ARABIAN AVE E, SHAKOPEE, MN 55379-4701
(952) 564-8067
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
9339
MN
Other
Enumeration date
08/25/2022
Last updated
08/25/2022
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