Individual
ELLEN MARIE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
3333 CHANATE RD, SANTA ROSA, CA 95404-1707
(707) 565-4900
Mailing address
3333 CHANATE RD, SANTA ROSA, CA 95404-1707
(707) 565-4900
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
374438
CA
Other
Enumeration date
04/13/2012
Last updated
04/13/2012
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