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ANTWANETTE ANTWANETTE GORDON
NPI 1629646104
Student in an Organized Health Care Education/Training Program in Mcdonough, GA

Active since June 11, 2021
429 CONCORD CIR, MCDONOUGH, GA 30253(470) 269-0878 Get Directions Write a Review

NPPES record last updated: June 11, 2021. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Antwanette Antwanette Gordon NPPES

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

ANTWANETTE ANTWANETTE GORDON (NPI 1629646104) is an individual student in an organized health care education/training program in Mcdonough, Georgia and active in the NPI registry since June 2021.

NPPES Registry Identity

NPI1629646104
Entity TypeIndividualFemale
Primary Taxonomy390200000X
Provider Legal NameANTWANETTE ANTWANETTE GORDON
Location Address429 CONCORD CIRMcdonough, GA 30253-8001
Mailing Address429 Concord CirMcdonough, GA 30253-8001 · (470) 269-0878
Phone(470) 269-0878
Sole ProprietorYes
Enumeration DateJune 11, 2021
NPPES CertifiedJune 11, 2021
✔ NPI 1629646104 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyStudent in an Organized Health Care Education/Training ProgramStudent, Health Care
Taxonomy Code390200000X
Definition
An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.
429 CONCORD CIR, Mcdonough, GA 30253
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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 Antwanette Gordon's NPI number?

The NPI number for Antwanette Gordon is 1629646104. It was assigned to this individual provider in the NPPES registry on June 11, 2021.

Where is Antwanette Gordon located?

Antwanette Gordon practices at 429 Concord Cir, Mcdonough, GA 30253. The listed phone number is (470) 269-0878.

What is Antwanette Gordon's specialty?

The primary specialty registered for this NPI is Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.

When was this NPI record last updated?

The NPPES record for Antwanette Gordon was last updated on June 11, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years 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.