| NPI | 1568022523 |
|---|---|
| Former Name | KRYSTAL K GORDON |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LP0222X Nurse Practitioner, Pediatrics, Critical Care (Licence: FL APRN11002846) |
| Enumeration Date | 2019-06-20 |
| Last Update Date | 2025-02-11 |