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Newly Listed Provider — this NPI profile has been added to the NPI registry within the last 30 days.

TARA RAE GORDIJENKO
NPI 1104749837
Licensed Practical Nurse in Bunker Hill, WV

Active since July 31, 2026
210 ISAAC DR, BUNKER HILL, WV 25413(681) 273-9995(681) 227-9995 Get Directions Write a Review

NPPES record added: July 31, 2026. Verified against the NPPES registry weekly; last sync: August 02, 2026.

About Tara Rae Gordijenko NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA RAE GORDIJENKO (NPI 1104749837) is an individual licensed practical nurse in Bunker Hill, West Virginia, licensed in Maryland (LP55602) and active in the NPI registry since July 2026.

NPPES Registry Identity

NPI1104749837
Entity TypeIndividualFemale
Primary Taxonomy164W00000X
Provider Legal NameTARA RAE GORDIJENKO
Location Address210 ISAAC DRBunker Hill, WV 25413-4267
Mailing Address210 Isaac DrBunker Hill, WV 25413-4267 · (681) 273-9995 · Fax (681) 227-9995
Phone(681) 273-9995
Fax(681) 227-9995
Sole ProprietorYes
Enumeration DateJuly 31, 2026
NPPES CertifiedJuly 31, 2026
✔ NPI 1104749837 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyLicensed Practical NurseNursing Service Providers
Taxonomy Code164W00000X
License✔ Licensed in MD · LP55602
Definition
A licensed practical nurse with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states.
210 ISAAC DR, Bunker Hill, WV 25413
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tara Gordijenko's NPI number?

The NPI number for Tara Gordijenko is 1104749837. It was assigned to this individual provider in the NPPES registry on July 31, 2026.

Where is Tara Gordijenko located?

Tara Gordijenko practices at 210 Isaac Dr, Bunker Hill, WV 25413. The listed phone number is (681) 273-9995.

What is Tara Gordijenko's specialty?

The primary specialty registered for this NPI is Licensed Practical Nurse with taxonomy code 164W00000X.

When was this NPI record last updated?

The NPPES record for Tara Gordijenko was last updated on July 31, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 days ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.