Individual
MRS. MITZI NICOLE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
1010 MEDICAL CENTER DR, POWDERLY, KY 42367-5463
(270) 377-1600
(270) 377-1675
Mailing address
5200 COMMERCE CROSSINGS DR FL 3, LOUISVILLE, KY 40229-2182
(502) 253-4924
(502) 489-5750
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
5639P
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100076140
—
KY
Enumeration date
10/01/2008
Last updated
12/08/2020
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