Healthcare Provider Details

I. General information

NPI: 1194937532
Provider Name (Legal Business Name): KAREN LEE GORDON-DAVIS PHD, APRN,BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/06/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1501 SULGRAVE AVE 206
BALTIMORE MD
21209-3654
US

IV. Provider business mailing address

1501 SULGRAVE AVE 206
BALTIMORE MD
21209-3654
US

V. Phone/Fax

Practice location:
  • Phone: 410-664-6700
  • Fax:
Mailing address:
  • Phone: 410-664-6700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code364SP0808X
TaxonomyPsychiatric/Mental Health Clinical Nurse Specialist
License NumberR038816
License Number StateMD
# 2
Primary TaxonomyN
Taxonomy Code102L00000X
TaxonomyPsychoanalyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: