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Individual

MRS. CHRISTINE ANN GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
2105 W GENESEE ST, SYRACUSE, NY 13219-1698
(315) 468-3239
(315) 468-2917
Mailing address
3157 FOX RD, SYRACUSE, NY 13215-9744
(315) 673-4464

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
211405-1
NY

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
211405-1
LPN LICENSE
NY
Enumeration date
03/01/2010
Last updated
03/01/2010
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