Provider Demographics
NPI:1669045993
Name:GORDON, KARLA (APRN)
Entity Type:Individual
Prefix:MRS
First Name:KARLA
Middle Name:
Last Name:GORDON
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:
Other - Last Name:DIJOHN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:APRN
Mailing Address - Street 1:55 W WATERLOO RD
Mailing Address - Street 2:
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44319-1019
Mailing Address - Country:US
Mailing Address - Phone:330-724-7715
Mailing Address - Fax:216-229-2646
Practice Address - Street 1:55 W WATERLOO RD
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44319-1019
Practice Address - Country:US
Practice Address - Phone:330-724-7715
Practice Address - Fax:216-229-2646
Is Sole Proprietor?:No
Enumeration Date:2021-07-23
Last Update Date:2022-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH0029350363LP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP2300XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPrimary Care