Individual
NICOLE L GARNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
670 PIERCE BLVD, O FALLON, IL 62269-2579
(618) 206-2094
Mailing address
670 PIERCE BLVD, O FALLON, IL 62269-2579
(618) 206-2094
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
085009221
IL
Other
Enumeration date
08/05/2022
Last updated
01/22/2025
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