Healthcare Provider Details

I. General information

NPI: 1558900902
Provider Name (Legal Business Name): APRIL A. GORDON NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/02/2020
Last Update Date: 12/03/2025
Certification Date: 12/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

156 FOSTER DR STE B
MCDONOUGH GA
30253-5346
US

IV. Provider business mailing address

156 FOSTER DR STE B
MCDONOUGH GA
30253-5346
US

V. Phone/Fax

Practice location:
  • Phone: 770-506-4119
  • Fax: 770-506-4145
Mailing address:
  • Phone: 770-506-4119
  • Fax: 770-506-4145

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberNP231339
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: