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Individual

MRS. SUSAN MARIE GARDNER

Active
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Individual

MRS. SUSAN MARIE GARDNER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
154843
MO
363LF0000X
Family Nurse Practitioner
46050
KS
363LP2300X
Primary Care Nurse Practitioner
Primary
154843
MO
363LP2300X
Primary Care Nurse Practitioner
46050
KS

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
154843
MO NURSING LICENSE
MO
Enumeration date
07/05/2007
Last updated
06/20/2017
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