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Individual

JENNIFER GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP-C

Contact information

Practice address
1955 TEXTILE WAY STE B, GAINESVILLE, GA 30501
(678) 987-1480
(678) 987-1481
Mailing address
1955 TEXTILE WAY STE B, GAINESVILLE, GA 30501-2543
(678) 987-1499
(678) 987-1498

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
RN198306
GA
363LA2200X
Adult Health Nurse Practitioner
198306
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
582238919
GASTROENTEROLOGY
GA
Enumeration date
08/13/2014
Last updated
08/17/2018
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