Individual provider · Type 1 NPI

Carolyn Jackman Gordon, CRNP, PMHNP-BC

Psychiatric/Mental Health Nurse Practitioner · Lumberton, NC

NPI number 1710711262 Active

Practice location

401 W 27th St
Lumberton, NC 28358-3019

Mailing address

34 Shining Willow Way # 239
La Plata, MD 20646-4224

Other practice locations

  • 34 Shining Willow Way # 239, La Plata, MD 20646-4224 · (015) 426-4753
  • 8040 Georgia Ave Ste 170, Silver Spring, MD 20910-4959 · (202) 360-4787

Specialties and licenses

TaxonomyCodeLicense
Psychiatric/Mental Health Nurse Practitioner Primary 363LP0808X5022591 (NC)
Psychiatric/Mental Health Nurse Practitioner 363LP0808XAC006921 (MD)

Psychiatric/Mental Health Nurse Practitioner: Definition to come...

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About NPI 1710711262

Carolyn Jackman Gordon, CRNP, PMHNP-BC's National Provider Identifier is 1710711262, issued on Aug 28, 2024. The primary taxonomy on file is Psychiatric/Mental Health Nurse Practitioner (363LP0808X), and the practice location is in Lumberton, NC. The record was last updated on Jul 23, 2026.