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Individual

MR. DANIEL PHILLIP GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
FNP

Contact information

Practice address
8725 COUNTY ROAD 64, DAPHNE, AL 36526
(251) 625-1370
(251) 625-1380
Mailing address
PO BOX 7987, MOBILE, AL 36670-0987
(251) 633-0573
(251) 633-7367

Taxonomy

Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
1-122937
AL
363LF0000X
Family Nurse Practitioner
Primary
1-122937
AL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
03323279
MS MEDICAID
MS
01
10138I3499
MEDICARE
AL
05
179179
AL
05
213045
AL
05
214334
AL
05
221246
AL
05
222164
AL
05
223477
AL
01
4992223
AETNA
AL
01
511-67959
BCBS
AL
01
511-70269
BCBS
AL
01
511-70270
BCBS
AL
01
511-95547
BCBS
AL
01
512-05546
BCBS
AL
01
512-05548
BCBS
AL
01
5581031
UHC
AL
01
P01572739
RR MEDICARE
AL
01
Z33078
VIVA HEALTH
AL
Enumeration date
06/04/2015
Last updated
02/23/2024
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