Individual
KENZIE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5885 S MAIN ST STE 1, CLARKSTON, MI 48346-2981
(614) 507-3765
Mailing address
5885 S MAIN ST STE 1, CLARKSTON, MI 48346-2981
(248) 238-8059
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
4704335952
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4704335952
NP LICENSE
MI
Enumeration date
01/11/2018
Last updated
11/21/2025
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