Individual
KAYLA M GARDIENT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
3563 PRAIRIEVIEW ST STE 200, GRAND ISLAND, NE 68803-4442
(402) 483-3333
Mailing address
PO BOX 6607, LINCOLN, NE 68506-0607
(402) 483-3333
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
825
NE
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
47084496100
—
NE
Enumeration date
08/28/2006
Last updated
09/08/2023
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