Individual provider · Type 1 NPI
Tara Rae Gordijenko
Licensed Practical Nurse · Bunker Hill, WV
NPI number
1104749837
Active
Practice location
210 Isaac Dr
Bunker Hill, WV 25413-4267
Fax (681) 227-9995
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Licensed Practical Nurse Primary | 164W00000X | LP55602 (MD) |
Licensed Practical Nurse: 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.
Other licensed practical nurse providers in Bunker Hill
About NPI 1104749837
Tara Rae Gordijenko's National Provider Identifier is 1104749837, issued on Jul 31, 2026. The primary taxonomy on file is Licensed Practical Nurse (164W00000X), and the practice location is in Bunker Hill, WV. The record was last updated on Jul 31, 2026.