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General NPI Number Information
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NPI Number | 1124597661
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Entity Type | Individual
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Provider Name | GORDON ADDO FNP-C
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Gender | Male
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Dates
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Enumeration Date | 11/14/2018
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Last Update Date | 01/26/2024
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Provider Practice Location Address
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Address Line | 500 W ANNANDALE RD
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City | FALLS CHURCH
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State | VA
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Zip | 22046-4205
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Country | US
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Telephone | 703-521-6662
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Fax |
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Provider Business Mailing Address
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Address Line | 1759 GRAY HAWK DR
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City | MISSOURI CITY
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State | TX
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Zip | 77489-4405
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Country | US
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Telephone | 973-309-2947
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | AP138305
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | NP500015050
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License Number State | DC
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Taxonomy #3
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 0024188682
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License Number State | VA
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