Provider Demographics
NPI:1326211335
Name:GORDON, SABINA GABRIELLE (FNP-C)
Entity Type:Individual
Prefix:
First Name:SABINA
Middle Name:GABRIELLE
Last Name:GORDON
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Mailing Address - Street 1:1365 ROCK QUARRY RD STE 304
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-5024
Mailing Address - Country:US
Mailing Address - Phone:678-890-2230
Mailing Address - Fax:678-826-0772
Practice Address - Street 1:1365 ROCK QUARRY RD STE 304
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-5024
Practice Address - Country:US
Practice Address - Phone:678-890-2230
Practice Address - Fax:678-826-0772
Is Sole Proprietor?:No
Enumeration Date:2008-04-10
Last Update Date:2020-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GARN219044363LF0000X
GAF05190272363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily