Dominique S Gordon, FNP-C, PMHNP-BC
Nurse Practitioner, Psych/Mental Health in Palm Bay, FL. Individual provider (NPI-1).
NPI number1982204178
StatusActive
Last updated in NPPESSep 8, 2026
Details
- NPI
- 1982204178
- Entity type
- Individual (NPI-1)
- Name
- Dominique S Gordon
- Credential
- FNP-C, PMHNP-BC
- Sex
- Female
- Sole proprietor
- Yes
- Enumeration date
- Oct 28, 2020
- Certification date
- Sep 8, 2026
- Last updated
- Sep 8, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363LP0808X | Nurse Practitioner, Psych/Mental Health | APRN11014427 | FL | Yes |
| 363LF0000X | Nurse Practitioner, Family | APRN11014427 | FL |
Practice location
160 Malabar Rd Sw Ste 112Palm Bay, FL 32907-2912
Phone 321-364-1094 · Fax 321-617-5863
Mailing address
160 Malabar Rd Sw Ste 112Palm Bay, FL 32907-2912
Phone 321-364-1094 · Fax 321-617-5863
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All 21 Psychiatric/Mental Health Nurse Practitioner providers in Palm Bay · All 1,789 providers in Palm Bay
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