Individual
MRS. JESSICA MARIE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
425 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3409
(859) 341-3575
(859) 341-5701
Mailing address
425 CENTRE VIEW BLVD, CRESTVIEW HILLS, KY 41017-3409
(859) 341-3575
(859) 341-5701
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA1647
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1098672
NCCPA
—
Enumeration date
07/01/2011
Last updated
08/30/2017
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