Gordon, Madonna K
Gordon, Madonna K is an individual health care provider with primary practice located at 1 Medical Center Dr , Lebanon NH 03756-1000. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Pediatrics, which is considered as her primary health care specialty. Gordon, Madonna K can be contacted via phone (603) 650-5000.Contact Information
Primary practice address
1 Medical Center Dr
Lebanon NH 03756-1000
Phone: (603) 650-5000
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Pediatrics | 363LP0200X | 061091-23 | New Hampshire |
Profile Details
| NPI number | 1790907319 |
|---|---|
| LBN Legal business name | Gordon, Madonna K |
| Credentials | ARNP |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 3rd, 2007 |
| Last updated | May 19th, 2017 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1790907319 | NPPES |
| Washington | MEDICAID | 9649831 |
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