MS. KONWRE GORDON FNP-BC NPI 1871048470

NPI Information

NPI: 1871048470
Provider Name: MS. KONWRE GORDON, FNP-BC
Classification: Nurse Practitioner - 363LF0000X
Entity Type: Individual

Specialization: Family

PECOS Registration: Yes

Address:
21040 GREENFIELD RD
OAK PARK, MI
ZIP 48237
Phone: (248) 967-6500
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MS. Konwre Gordon, FNP-BC is a family nurse practitioner in Oak Park, MI with 8 years of experience. MS. Konwre Gordon, FNP-BC NPI is 1871048470. 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:

21040 GREENFIELD RD
OAK PARK, MI
ZIP 48237-025
Phone: (248) 967-6500
Fax: (248) 967-6528

The NPI 1871048470 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 8/24/2016 and was last updated on 8/13/2020.

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	363LF0000X	Nurse Practitioner	Family	4704257255	MICHIGAN	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: 4/28/2024

NPI Synchronization or Removal

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