Individual
DIANA GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
30 HUNTER LN, CAMP HILL, PA 17011-2499
(800) 748-3243
Mailing address
79910 MEMORIAL PLACE, LA QUINTA, CA 92253
(760) 345-8578
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
560093
CA
Other
Enumeration date
04/25/2021
Last updated
04/25/2021
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