Individual
NANCY VADEN GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
5649 COVENTRY LN, FORT WAYNE, IN 46804-7145
(260) 436-6565
(260) 459-1130
Mailing address
5649 COVENTRY LN, FORT WAYNE, IN 46804-7145
(260) 436-6565
(260) 459-1130
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
28070434A
IN
363L00000X
Nurse Practitioner
Primary
71002326A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200994690
—
IN
Enumeration date
02/01/2007
Last updated
06/23/2014
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