SHIRLEY GORDON RN NPI 1073531349

NPI Information

NPI: 1073531349
Provider Name: SHIRLEY GORDON, RN
Classification: Registered Nurse - 163WC0200X
Entity Type: Individual

Specialization: Critical Care Medicine

Address:
9975 DWAYNE CT
MENTOR, OH
ZIP 44060
Phone: (440) 354-1553
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Shirley Gordon, RN is a critical care medicine registered nurse in Mentor, OH. Shirley Gordon, RN NPI is 1073531349. 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:

9975 DWAYNE CT
MENTOR, OH
ZIP 44060-252
Phone: (440) 354-1553
Fax: (440) 354-1553

The enumeration date for this NPI number is 7/17/2006 and was last updated on 7/9/2007.

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	163WC0200X	Registered Nurse	Critical Care Medicine	RN194973	OHIO	Yes
2	163WC3500X	Registered Nurse	Cardiac Rehabilitation	RN 194973	OHIO	X
3	163WE0003X	Registered Nurse	Emergency	RN194973	OHIO	X
4	163WG0000X	Registered Nurse	General Practice	RN 194973	OHIO	X
5	163WH0200X	Registered Nurse	Home Health	RN194973	OHIO	X
6	163WI0500X	Registered Nurse	Infusion Therapy	RN194973	OHIO	X
7	163WM0705X	Registered Nurse	Medical-Surgical	RN 194973	OHIO	X
8	163WP0200X	Registered Nurse	Pediatrics	RN194973	OHIO	X
9	163WS0200X	Registered Nurse	School	RN194973	OHIO	X
10	163WW0000X	Registered Nurse	Wound Care	RN 194973	OHIO	X

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	2171582	MEDICAID	OHIO

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: 4/28/2024

NPI Synchronization or Removal

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