Individual
MINDI GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CNP
Contact information
Practice address
4600 MONTGOMERY RD, STE 105, CINCINNATI, OH 45212-2697
(513) 487-5305
(513) 487-5317
Mailing address
10496 MONTGOMERY RD, STE 110, CINCINNATI, OH 45242-5223
(513) 791-7572
(513) 791-8240
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
07302-NP
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000361570
ANTHEM BLUE SHIELD
—
05
—
200442150
—
IN
05
—
2412008
—
OH
01
—
7707682
AETNA
—
05
—
78010089
—
KY
Enumeration date
12/07/2005
Last updated
08/02/2011
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