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Individual
ABIGAIL B. GARDNER
Active
Individual
ABIGAIL B. GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1708
KY
363A00000X
Physician Assistant
TC095
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000759487
ANTHEM - NOS
KY
01
—
135234
SIHO - NOTC
KY
01
—
50040098
PASSPORT - NOTC
KY
05
—
7100205790
—
KY
01
—
P01205327
MEDICARE - RR
KY
Enumeration date
04/10/2012
Last updated
07/21/2022
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