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Mrs. Jessica M Gordon
Private Vehicle in Fort Wayne, Indiana
NPI 1518359736

Jessica M Gordon is a Private Vehicle based in Fort Wayne, IN. Jessica M Gordon practices in Fort Wayne, IN. The NPI Number for Jessica M Gordon is 1518359736 and holds a License No. 0501147343 (Indiana).

The current practice location address for Jessica M Gordon is 4703 Highwood Dr, Fort Wayne, IN and can be reached out via phone at 260-797-3604.

Location: 4703 Highwood Dr, Fort Wayne, IN, 46815-6067
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1518359736
Provider Name
Jessica M Gordon
Credential
Provider Entity Type
Individual
Gender
Female
Address
4703 Highwood Dr, Fort Wayne, IN, 46815-6067
Phone Number
260-797-3604
Fax Number
Provider Enumeration Date
02/25/2015
Last Update Date
03/09/2024
institution
Provider Business Practice Location Address Details
Address
4703 Highwood Dr
City
Fort Wayne
State
Indiana
Zip
46815-6067
Phone Number
260-797-3604
Fax Number
person
Provider Business Mailing Address Details
Address
4703 Highwood Dr
City
Fort Wayne
State
Indiana
Zip
46815-6067
Phone Number
260-797-3604
Fax Number
person
Provider's Taxonomy Details 1
Type
Transportation Services
Classification
Private Vehicle
Speciality
-
Taxonomy
347C00000X
License No.
0501147343 (Indiana)
Definition
An individual paid to provide non-emergency transportation using their privately owned/leased vehicle.
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