Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Gina Gordenier

Individual provider Gerontology Nurse Practitioner · NPI 1659193928

Gina Gordenier is a Nurse Practitioner in Mishawaka, Indiana. Qualified in 2024, 2 years ago. Practices with Kidney Care of Michiana LLC, a 6-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
2
Licensed in
IN
In the registry since
2024
Specialties on file
2

Practice location Address checks out

515 Park Place Cir Ste 200
Mishawaka, IN 46545-3585
Phone: (574) 607-4724
Fax: (574) 607-4725
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Acute Care Nurse Practitioner (primary) Taxonomy 363LA2100X · Licence 71015969A (IN)
Gerontology Nurse Practitioner Taxonomy 363LG0600X · Licence 71015969A (IN)

Record details

NPI number1659193928
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedOctober 29, 2024
Last updated in NPPESOctober 29, 2024
Certification dateOctober 18, 2024

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2024 (2 years in practice)
Group practice Kidney Care Of Michiana Llc — 6 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mishawaka