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Individual

MRS. ANNA PETTY GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CRNP

Contact information

Practice address
2214 GATEWAY DR STE C, OPELIKA, AL 36801-6832
(334) 741-0075
Mailing address
2214 GATEWAY DR STE C, OPELIKA, AL 36801-6832
(334) 741-0075
(334) 741-4075

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-163163
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
F04210240
CERTIFICATION NUMBER
AL
Enumeration date
05/31/2021
Last updated
01/02/2024
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