Provider Demographics
NPI:1861844482
Name:GORDON, BRITTANY JOY (APRN, CNP)
Entity Type:Individual
Prefix:
First Name:BRITTANY
Middle Name:JOY
Last Name:GORDON
Suffix:
Gender:F
Credentials:APRN, CNP
Other - Prefix:
Other - First Name:BRITTANY
Other - Middle Name:JOY
Other - Last Name:SCHWENDEMANN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 1309
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1309
Mailing Address - Country:US
Mailing Address - Phone:952-883-7172
Mailing Address - Fax:
Practice Address - Street 1:2251 CONNECTICUT AVE S
Practice Address - Street 2:
Practice Address - City:SARTELL
Practice Address - State:MN
Practice Address - Zip Code:56377-2486
Practice Address - Country:US
Practice Address - Phone:320-253-5220
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-07-07
Last Update Date:2016-10-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 4591363LF0000X
MNR206914-6363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily