Individual provider · Type 1 NPI

Anna Crow Gordon

Nurse Practitioner · Southaven, MS

NPI number 1124765656 Active

Practice location

60 Physicians Ln
Southaven, MS 38671-6122

Call (769) 243-6141 Map

Fax (601) 510-1665

Mailing address

778 Liberty Rd
Flowood, MS 39232-9300

Specialties and licenses

TaxonomyCodeLicense
Nurse Practitioner Primary 363L00000X904651 (MS)

Nurse Practitioner: (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance wit…

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About NPI 1124765656

Anna Crow Gordon's National Provider Identifier is 1124765656, issued on May 16, 2022. The primary taxonomy on file is Nurse Practitioner (363L00000X), and the practice location is in Southaven, MS. The record was last updated on Sep 28, 2025.