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Individual

TANNEKU GARDNER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
LPN

Contact information

Practice address
316 HALTON CROSSING DR SW, CONCORD, NC 28027-9432
(704) 794-3178
Mailing address
316 HALTON CROSSING DR SW, CONCORD, NC 28027-9432
(704) 794-3178

Taxonomy

Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
PN113538
OH

Other

Enumeration date
08/20/2011
Last updated
01/27/2022
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