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Individual

MS. BRENDALYN ANN GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
7303 SLOAN PL NE, ATLANTA, GA 30329-4315
(404) 982-0987
(404) 982-0987
Mailing address
7303 SLOAN PL NE, ATLANTA, GA 30329-4315
(404) 982-0987
(404) 982-0987

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
LPN036703
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
036703
LPN
GA
Enumeration date
01/29/2009
Last updated
01/29/2009
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