Individual
MR. DAVID ALLEN GARDNER JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
593 EDDY STREET, APC MAIN, PROVIDENCE, RI 02903
(401) 444-5435
(401) 444-8301
Mailing address
117 ELLENFIELD ST STE 101, PROVIDENCE, RI 02905-4513
(401) 444-6779
(401) 444-6912
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
APRN01860
RI
363LA2200X
Adult Health Nurse Practitioner
APRN01860
RI
363LG0600X
Gerontology Nurse Practitioner
APRN01860
RI
Other
Enumeration date
08/09/2018
Last updated
09/19/2018
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