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Marian Kathleen Gordon

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

4048 Dressler Rd NW, Canton, OH 44718-2784

PECOS Enrollment

This provider is enrolled in PECOS as MARIAN GORDON.

Based on the most recent information from CMS, provider Marian Kathleen Gordon is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 2 days ago.

Profile Details

Provider ID
1386399822
Provider Type
Individual
Full Name
Gordon, Marian Kathleen
Credential
CNP

Gender
Female
Sole Proprietor
No
Enumeration Date
2/14/2022
Last Updated
2/14/2022

Contact Information

Practice Location

4048 Dressler Rd NW, Canton, OH 44718-2784

(330) 478-4132

(330) 478-3341

Mailing Location

4048 Dressler Rd NW, Canton, OH 44718-2784

(330) 478-4132

(330) 478-3341

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 024695 Ohio

Marian Kathleen Gordon

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Pandey, Sanjana

Tannhof, Ashley Marie

Davis, Kirsten Lyn

Trent, Elizabeth

Gnes, Dawn C

Holcomb, Taylor Nicole

Cochran, Candace

Stockert, Stacie

Simmons, Wanda

Laughlin, Ashley