Healthcare Provider Details

I. General information

NPI: 1184541104
Provider Name (Legal Business Name): WHITNEY GORDON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/01/2026
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5783 DARROW RD
HUDSON OH
44236-3866
US

IV. Provider business mailing address

3284 S CANAL ST
NEWTON FALLS OH
44444-9478
US

V. Phone/Fax

Practice location:
  • Phone: 866-398-2727
  • Fax:
Mailing address:
  • Phone: 330-883-1050
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number0042589
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: