NICOLE GORDON NP NPI 1982789939

NPI Information

NPI: 1982789939
Provider Name: NICOLE GORDON, NP
Classification: Nurse Practitioner - 363LG0600X
Entity Type: Individual

Specialization: Gerontology

Organization: ELLIOT PROFESSIONAL SERVICES

PECOS Registration: Yes

Address:
138 WEBSTER ST
MANCHESTER, NH
ZIP 03104
Phone: (603) 663-7030
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Nicole Gordon, NP is a gerontology nurse practitioner in Manchester, NH with 20 years of experience. Nicole Gordon, NP NPI is 1982789939. 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:

138 WEBSTER ST
MANCHESTER, NH
ZIP 03104-512
Phone: (603) 663-7030
Fax: (603) 663-7039

The NPI 1982789939 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 10/26/2006 and was last updated on 2/2/2010.

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	363L00000X	Nurse Practitioner		254623	MASSACHUSETTS	No
2	363LG0600X	Nurse Practitioner	Gerontology	254623	MASSACHUSETTS	No
3	363LG0600X	Nurse Practitioner	Gerontology	053134-23	NEW HAMPSHIRE	Yes

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
1	0700576	MEDICAID	MASSACHUSETTS
2	NP4658	MEDICARE PIN	MASSACHUSETTS
3	Q20604	MEDICARE UPIN	MASSACHUSETTS

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: 11/14/2023

NPI Synchronization or Removal

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