Individual
SHIRLENE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
7500 N DREAMY DRAW DR, PHOENIX, AZ 85020-4660
(269) 532-3380
Mailing address
PO BOX 5384, GLENDALE, AZ 85312-5384
(269) 532-3380
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LP046305
AZ
Other
Enumeration date
09/24/2015
Last updated
09/24/2015
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