Gordon, Nicole

Gordon, Nicole is an individual health care provider with primary practice located at 138 Webster St , Manchester NH 03104-2512. She recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner, Physician Assistants & Advanced Practice Nursing Providers / Gerontology. Physician Assistants & Advanced Practice Nursing Providers / Gerontology is her primary health care specialty. Gordon, Nicole can be contacted via phone (603) 663-7030.

Contact Information

Primary practice address
138 Webster St Manchester NH 03104-2512
Phone: (603) 663-7030
Fax: (603) 663-7039
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Nurse Practitioner 363L00000X 254623 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 254623 Massachusetts
Physician Assistants & Advanced Practice Nursing Providers / Gerontology 363LG0600X 053134-23 New Hampshire

Profile Details

NPI number 1982789939
LBN Legal business name Gordon, Nicole
Credentials Nurse Practitioner (NP)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 26th, 2006
Last updated Feb 2nd, 2010 - about 14 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 1982789939 NPPES
Massachusetts MEDICAID 0700576

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