Individual
LANETTE J GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
285 W 800 S, ROOSEVELT, UT 84066-3707
(435) 725-6300
(435) 725-6325
Mailing address
559 E 700 N, ROOSEVELT, UT 84066-2434
(435) 725-6300
(435) 725-6325
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
263829-3101
UT
Other
Enumeration date
05/17/2007
Last updated
07/08/2007
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