Provider Demographics
NPI:1639870918
Name:GORDON, JAMIE (WHNP)
Entity Type:Individual
Prefix:MS
First Name:JAMIE
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7195 CEDAR CREEK RD
Mailing Address - Street 2:
Mailing Address - City:LINCOLN
Mailing Address - State:DE
Mailing Address - Zip Code:19960-2667
Mailing Address - Country:US
Mailing Address - Phone:302-503-0741
Mailing Address - Fax:302-424-9302
Practice Address - Street 1:7195 CEDAR CREEK RD
Practice Address - Street 2:
Practice Address - City:LINCOLN
Practice Address - State:DE
Practice Address - Zip Code:19960-2667
Practice Address - Country:US
Practice Address - Phone:302-503-0741
Practice Address - Fax:302-424-9302
Is Sole Proprietor?:No
Enumeration Date:2023-03-14
Last Update Date:2023-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELH-0010272207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology