NPI 1003539792
Samantha Shyanne Gordon, CNA
Practice location
- Address
- 227235 Teal Ave, Wausau, WI 54401-2557
- Phone
- (630) 826-9753
- Mailing address
- 16192 Coastal Hwy, Lewes, DE 19958-3608
Registered specialties
Home Health Aide
Primary
Registry record
- NPI
- 1003539792
- Entity type
- Individual
- Sex (as registered)
- Female
- NPI issued
- 19 Sep 2022
- Record last updated
- 19 Sep 2022
Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.