Individual
JENNA GLORIA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CAA
Contact information
Practice address
10315 DAWSONS CREEK BLVD STE AB, FORT WAYNE, IN 46825-1912
(260) 436-7875
Mailing address
PO BOX 843603, DALLAS, TX 75284-3603
(972) 233-1999
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
75000170A
IN
367H00000X
Anesthesiologist Assistant
AA2000022
DC
Other
Enumeration date
02/07/2022
Last updated
02/06/2024
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