Gordon, Alisa Joy

Gordon, Alisa Joy is an individual health care provider with primary practice located at 13220 Woodward Ave , Highland Park MI 48203-3610. She recently has only one registered license in Nursing Service Providers / Licensed Practical Nurse, which is considered as her primary health care specialty. Gordon, Alisa Joy can be contacted via phone (313) 868-1946.

Contact Information

Primary practice address
13220 Woodward Ave Highland Park MI 48203-3610
Phone: (313) 868-1946
Fax: (313) 852-1631
Website:
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Health care specialties

SpecialtyCodeLicense #State
Nursing Service Providers / Licensed Practical Nurse 164W00000X 4703056485 Michigan

Profile Details

NPI number 1386762185
LBN Legal business name Gordon, Alisa Joy
Credentials Licensed Practical Nurse (LPN)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 27th, 2007
Last updated Jul 9th, 2007 - about 17 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1386762185 NPPES
Michigan Other 1740313238 CHRISTIAN GUIDANCE CENTER
Michigan MEDICAID 3022440 CHRISTIAN GUIDANCE CENTER

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