MRS. STEPHANIE JO GORDON (NPI# 1750513750) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1750513750 |
| Entity Type | Individual |
| Full Name | MRS. STEPHANIE JO GORDON |
| Other Name | MRS. STEPHANIE JO NIKLAUS |
| Credential | ANP-BC |
| Practice Address |
4310 Nicollet Ave Minneapolis MN 55409-2033 |
| Mailing Address |
3443 24th Ave S Minneapolis MN 55406-2501 |
| Practice Telephone | 6128238001 |
| Mailing Telephone | 6127304634 |
| Enumeration Date | 2009-08-10 |
| Last Update Date | 2009-08-10 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LA2200X |
Nurse Practitioner Specialization: Adult Health |
2009006856 | MN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578970968 | Stephanie Gordon | Specialist/Technologist | 198 Heather Dr, Central, SC 29630-9308 | 2014-07-17 |
| 1619309945 | Stephanie Jean Gordon | Acupuncturist | 410 Wabash St, Michigan City, IN 46360-3334 | 2013-08-09 |
| 1629376835 | Stephanie Vicky Gordon | Massage Therapist | 2874 Shelby St, Suite 108, Bartlett, TN 38134-4579 | 2011-03-11 |
| 1750516159 | Stephanie Spurlock Gordon | Dental Hygienist | 1245 Nw 119th St, Miami, FL 33167-3231 | 2009-05-29 |
| 1366564288 | Stephanie Ward Gordon | Pharmacist | 7880 Winn Rd, Spring Grove, IL 60081-9687 | 2007-04-03 |
| 1407849722 | Stephanie H Gordon | Obstetrics & Gynecology | 2750 Owens Rd Sw, Suite A, Conyers, GA 30094-3991 | 2005-08-23 |
| 1386121366 | Stephanie Gordon | Dentist | 736 E Oak St, Oakland, MD 21550-1615 | 2018-07-23 |
| 1356864110 | Stephanie Christine Gordon | Licensed Practical Nurse | 2216 20th St, Zion, IL 60099-1648 | 2017-07-24 |
| 1174992127 | Stephanie Gordon | Advanced Practice Midwife | 611 W Park St, Urbana, IL 61801-2529 | 2015-09-21 |
| 1003234840 | Stephanie Gordon | Social Worker | 1900 S Acadian Thruway, Baton Rouge, LA 70808-1665 | 2014-03-30 |
| Street Address |
4310 NICOLLET AVE |
| City | MINNEAPOLIS |
| State | MN |
| Zip Code | 55409-2033 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457466203 | Bio-medical Applications of Minnesota, Inc. | Clinic/Center | 4310 Nicollet Ave, Minneapolis, MN 55409-2033 | 2006-08-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629575493 | Twin Cities Music Therapy Services, LLC | Music Therapist | 3754 Pleasant Ave S., #105, Minneapolis, MN 55409 | 2018-04-09 |
| 1295100881 | Oliver Ross | Psychologist | 3802a Grand Avenue South, Minneapolis, MN 55409 | 2015-12-08 |
| 1093144750 | Nicole Pattee | Social Worker | 3751 Nicollet Ave, Minneapolis, MN 55409 | 2013-11-04 |
| 1598817678 | City of Minneapolis | Clinic/Center | 3131 19th Avenue South, Room 122, Minneapolis, MN 55409 | 2007-01-17 |
| 1366544587 | Robert C Shepherd | Chiropractor | 2415 Hennepin Ave S, Minneapolis, MN 55409 | 2006-09-01 |
| 1922563600 | Karlene Manitowich | Chiropractor | 3706 Nicollet Ave, Minneapolis, MN 55409 | 2019-02-06 |
| 1508385246 | Jessica Lynn Dahlton | Acupuncturist | 708 W 40th St, Minneapolis, MN 55409 | 2017-09-13 |
| 1508395575 | Daniel Scott Ronken | Counselor | 3802a Grand Avenue South, Minneapolis, MN 55409 | 2017-06-05 |
| 1447538608 | Jonee Elizabeth Meagher | Optometrist | 4243 4th Ave S, Minneapolis, MN 55409 | 2011-07-21 |
| 1760532683 | Larry G Tucker | Marriage & Family Therapist | 310 E 38th St, Suite 320, Minneapolis, MN 55409 | 2007-01-11 |
| Find all providers in zip 55409 | ||||
| Taxonomy Code | 363LA2200X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Adult Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942762828 | Jodi Lynn Martin | Nurse Practitioner | 720 Washington Ave Se Ste 300, Minneapolis, MN 55414-2904 | 2019-04-01 |
| 1437506417 | Zahra Roble | Nurse Practitioner | 1801 Nicolllet Ave S, Minneapolis, MN 55403 | 2016-05-19 |
| 1891170593 | Lindsey Smith | Nurse Practitioner | 421 18th Ave N, Minneapolis, MN 55411-3314 | 2015-07-23 |
| 1689068421 | Bridget Flynn | Nurse Practitioner | 6100 11th Ave S, Minneapolis, MN 55417-3208 | 2015-03-18 |
| 1386931178 | Abimbola Adenike Matti | Nurse Practitioner | 732 E Lake St, Pain Relief Center of Minnesota, Minneapolis, MN 55407-1547 | 2011-06-30 |
| 1235421660 | Meghann Rae Cody | Nurse Practitioner | 500 Harvard St Se Unit 7d, Minneapolis, MN 55455-0363 | 2011-05-04 |
| 1710218151 | Sheila Kathleen Smith | Nurse Practitioner | 814 S 3rd St, Minneapolis, MN 55415 | 2010-01-25 |
| 1295926129 | Michelle A Aldrich Rn Cnp Pa | Nurse Practitioner | 4215 31st Ave S, Minneapolis, MN 55406-3311 | 2007-08-06 |
| 1881783801 | Denise Rae Erickson | Nurse Practitioner | One Verans Dr., Minneapolis, MN 55417 | 2006-10-11 |
| 1316972011 | Jean H Lewis | Nurse Practitioner | 1 Veterans Dr Ive 112d, Minneapolis, MN 55417-2309 | 2006-07-11 |
| Find all providers in MINNEAPOLIS | ||||
| City | MINNEAPOLIS |
| Zip Code | 55409 |
Please comment or provide details below to improve the information on MRS. STEPHANIE JO GORDON.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.