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NPI Code Detail

MEDICARE: STEPHANIE ELYSE GORDON

MEDICARE: STEPHANIE ELYSE GORDON
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
13747P1801XPersonal Care Attendant

General Provider Information

NPI Number : 1346054988
Entity Type Code : Individual
Provider Name (Legal Business Name) : STEPHANIE ELYSE GORDON
Provider Business Mailing Address
First Line : 903 BELLEVUE BLVD N
Second Line :
City : BELLEVUE
State : NE
Zip : 68005-4332
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 619 OLSON DR
Second Line :
City : PAPILLION
State : NE
Zip : 68046-4770
Country : US
Telephone Number : 402-597-3336
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 02/04/2025
Last Update Date : 02/04/2025

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Directions to “ STEPHANIE ELYSE GORDON ” Practice Location

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These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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