Individual
TARA GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CRNA
Contact information
Practice address
9019 GENEVA CIR, PROSPECT, KY 40059-8583
(270) 564-0793
Mailing address
9019 GENEVA CIR, PROSPECT, KY 40059-8583
(270) 564-0793
Taxonomy
Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
3010026
KY
Other
Enumeration date
12/21/2015
Last updated
01/09/2016
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