PHEBE GORDON NPC NPI 1093264996

NPI Information

NPI: 1093264996
Provider Name: PHEBE GORDON, NPC
Classification: Nurse Practitioner - 363LP0200X
Entity Type: Individual

Specialization: Pediatrics

PECOS Registration: Yes

Address:
1027 WASHINGTON AVE
DETROIT LAKES, MN
ZIP 56501
Phone: (218) 847-5611
Get Directions

Phebe Gordon, NPC is a pediatrics nurse practitioner in Detroit Lakes, MN. Phebe Gordon, NPC NPI is 1093264996. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1027 WASHINGTON AVE
DETROIT LAKES, MN
ZIP 56501-409
Phone: (218) 847-5611

The NPI 1093264996 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/3/2016 and was last updated on 12/21/2016.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LP0200X	Nurse Practitioner	Pediatrics	CNP 4837	MINNESOTA	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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