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Organization
STACY GARDNER
Active
Organization
STACY GARDNER
Active
Other names
Professional Health Services
Organization subpart
No
Provider details
NPI number
Authorized official
STACY GARDNER FNP-BC (FAMILY NURSE PRACTITIONER/ OWNER)
(618) 932-2200
Entity
Organization
Contact information
Practice address
410 W SAINT LOUIS ST, WEST FRANKFORT, IL 62896-1956
(618) 932-2200
(618) 932-2202
Mailing address
410 W SAINT LOUIS ST, WEST FRANKFORT, IL 62896-1956
(618) 932-2200
(618) 932-2202
Taxonomy
Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
209007026
IL
363LF0000X
Family Nurse Practitioner
Primary
—
—
Other
Enumeration date
03/27/2008
Last updated
08/17/2009
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