Individual provider · Type 1 NPI

Tyriss Iman Gordon, FNP

Family Nurse Practitioner · Charlotte, NC

NPI number 1790657500 Active

Practice location

9915 Park Cedar Dr
Charlotte, NC 28210-8905

Mailing address

6136 Hailstone Rd
Charlotte, NC 28215-2888

Specialties and licenses

TaxonomyCodeLicense
Family Nurse Practitioner Primary 363LF0000X5023121 (NC)

Family Nurse Practitioner: Definition to come...

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About NPI 1790657500

Tyriss Iman Gordon, FNP's National Provider Identifier is 1790657500, issued on Sep 22, 2025. The primary taxonomy on file is Family Nurse Practitioner (363LF0000X), and the practice location is in Charlotte, NC. The record was last updated on Sep 22, 2025.