Mrs Ellen M Gordon, LPN is a
Licensed Practical Nurse based in Riverside, Ohio. Mrs Ellen M Gordon is licensed to practice in Ohio (license number PN095501) and her current practice location is
1523 Wake Ave, Riverside, Ohio. She can be reached at her office (for appointments etc.) via phone at
(937) 623-9143.
NPI number for Mrs Ellen M Gordon is 1417924572 and her current mailing address is 1523 Wake Ave, Riverside, Ohio. She
does not participate in medicare program and thus does not accept medicare assignments. Her NPI Number is 1417924572.
Provider's Profile
| Full Name | Mrs Ellen M Gordon |
|---|
| Gender | Female |
|---|
| Speciality | Licensed Practical Nurse |
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| Location | 1523 Wake Ave, Riverside, Ohio |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. She may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1417924572
- Provider Enumeration Date: 03/07/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Mrs Ellen M Gordon such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1417924572 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 164W00000X | Licensed Practical Nurse | PN095501 (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. Mrs Ellen M 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 |
|---|
Mrs Ellen M Gordon, LPN
1523 Wake Ave,
Riverside, OH 45431-1235
Ph: (937) 623-9143 | Mrs Ellen M Gordon, LPN
1523 Wake Ave,
Riverside, OH 45431-1235
Ph: (937) 623-9143 |
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