Individual provider · NPI-1

Madonna K Gordon, ARNP

Nurse Practitioner, Pediatrics · Lebanon, NH

NPI number1790907319
StatusActive
Last updated in NPPESMay 19, 2017

Details

NPI
1790907319
Entity type
Individual (NPI-1)
Name
Madonna K Gordon
Credential
ARNP
Sex
Female
Sole proprietor
No
Enumeration date
May 3, 2007
Last updated
May 19, 2017

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
363LP0200X Nurse Practitioner, Pediatrics061091-23NHYes

Practice location

1 Medical Center Dr
Lebanon, NH 03756-1000

Phone 603-650-5000

Mailing address

1 Medical Center Dr
Lebanon, NH 03756-1000

Phone 603-650-5000

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