Mutinta Gordon
Licensed Practical Nurse • Bridgeport, CT
Notice of NPI Deactivation & Inactive Practice Status
According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, Mutinta Gordon has officially deactivated this NPI record and ceased active healthcare practice.
Professional Overview & Biography Verified Profile Summary
Mutinta Gordon was a registered Licensed Practical Nurse practicing in Bridgeport, CT. Throughout an active medical career spanning 15 years, Mutinta Gordon provided care at the practice location at 25 KNOLL PL until profile deactivation on 2022-04-20.
Practice Location & Contact Primary Location
25 Knoll Pl
Bridgeport, CT 066101429
Specialty Benchmarks & Practice Insights
Comparative analytics for Licensed Practical Nurse in Bridgeport, CT
Practicing in Bridgeport, CT (389 Statewide)
In-Person Office Visits Only
Under CMS Medicare Fee Schedule vs Standard Submitted Charges
Medical Specialties & State Licenses
NUCC Taxonomy Code: 164W00000X
An individual 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.
Career & Practice History Timeline
Chronological log of verified NPI updates, location relocations, credentials, and registry changes
Record deactivated on April 20, 2022
NPI status registered as active in NPPES database
Registered at 25 KNOLL PL, BRIDGEPORT, CT 066101429 (Tel: 2039237333)
Registered at 25 KNOLL PL, BRIDGEPORT, CT 066101429 (Tel: 2039237333)
Recorded as MUTINTA GORDON
Licensed Practical Nurse (License #288939-1 in NY)
First registered as active Individual Practitioner in NPPES Database.
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NPI Administrative Meta
Mailing Address
25 Knoll Pl
Bridgeport, CT 066101429
Phone: 2039237333
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