(800) 868-1923

Most Relevant Information


Provider Data
NPI Number: 1003539792
Provider Name: SAMANTHA SHYANNE GORDON CNA
Entity Type: Individual
Taxonomy Code: 374U00000X
Specialty: Home Health Aide
License Number:
Most Important Dates
Enumeration Date: 09/19/2022
Last Updated: 09/19/2022
Provider Practice Location
227235 TEAL AVE
WAUSAU
WI
544012557
Practice Location Phone/Fax
Phone: 6308269753
Fax:
Provider Mailing Location
16192 COASTAL HWY
LEWES
DE
199583608
Provider Mailing Phone/Fax
Phone:
Fax: