Mary Ellen Gordon, CNP is a
Nurse Practitioner - Family based in Woodburn, Indiana. Mary Ellen Gordon is licensed to practice in Ohio (license number RN265977) and her current practice location is
18906 Old 24, Woodburn, Indiana. She can be reached at her office (for appointments etc.) via phone at
(260) 493-8141.
NPI number for Mary Ellen Gordon is 1649729872 and her current mailing address is 18906 Old 24, Woodburn, Indiana. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1649729872.
Provider's Profile
| Full Name | Mary Ellen Gordon |
|---|
| Gender | Female |
|---|
| Speciality | Nurse Practitioner - Family |
|---|
| Location | 18906 Old 24, Woodburn, Indiana |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
NPI Data:
- NPI Number: 1649729872
- Provider Enumeration Date: 09/29/2016
- Last Update Date: 04/01/2026
Medical Identifiers
Medical identifiers for Mary Ellen Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
| 1649729872 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
| 363LF0000X | Nurse Practitioner - Family | 71012009B (Indiana) | Secondary |
| 363LF0000X | Nurse Practitioner - Family | RN265977 (Ohio) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Mary Ellen Gordon is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
Mary Ellen Gordon, CNP 18906 Old 24, Woodburn, IN 46797-9048 Ph: (260) 493-8141 | Mary Ellen Gordon, CNP 18906 Old 24, Woodburn, IN 46797-9048 Ph: (260) 493-8141 |
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