Individual
MISS JENNIFER L GARDNER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
713 MATHER ST, GREEN BAY, WI 54303-3559
(920) 309-1486
Mailing address
713 MATHER ST, GREEN BAY, WI 54303-3559
(920) 309-1486
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
312658-31
WI
374U00000X
Home Health Aide
291818
WI
376K00000X
Nurse's Aide
291818
WI
Other
Enumeration date
04/12/2012
Last updated
05/21/2012
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