Individual
SHELBY LEE GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
AGACNP-BC
Contact information
Practice address
530 NE GLEN OAK AVE, PEORIA, IL 61637-0001
(309) 624-5000
Mailing address
11417 CHASE LN, BRIMFIELD, IL 61517-9538
(309) 231-2493
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
209.031548
IL
363LG0600X
Gerontology Nurse Practitioner
209031548
IL
Other
Enumeration date
02/01/2025
Last updated
02/04/2025
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