Individual
DR. JESSICA ELENA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
7021 HARBOUR VIEW BLVD STE 119, SUFFOLK, VA 23435-2869
(757) 953-7000
(757) 953-5025
Mailing address
9514 N RIVER RD, SUFFOLK, VA 23435-3359
(919) 601-7707
(757) 953-5025
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
0101249412
VA
390200000X
Student in an Organized Health Care Education/Training Program
0116021373
VA
390200000X
Student in an Organized Health Care Education/Training Program
2008015974
MO
Other
Enumeration date
07/02/2008
Last updated
03/07/2023
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