Individual provider · NPI-1

Shennel Gordon

Technician · Newport News, VA

NPI number1699598771
StatusActive
Last updated in NPPESMay 20, 2026

Details

NPI
1699598771
Entity type
Individual (NPI-1)
Name
Shennel Gordon
Sex
Female
Sole proprietor
Yes
Enumeration date
Nov 6, 2024
Certification date
May 20, 2026
Last updated
May 20, 2026

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
374700000X Technician––Yes

Practice location

13176 Jefferson Ave Ste C
Newport News, VA 23608-1322

Phone 757-585-4365

Mailing address

13176 Jefferson Ave Ste C
Newport News, VA 23608-1322

Phone 757-585-4365

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