Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 363LC1500X | Nurse Practitioner - Community Health | UP003792-B | PA |
N | 363LF0000X | Nurse Practitioner - Family Medicine | UP003792B | PA |
NPI | 1497757322 |
---|---|
Provider Name | Anna M. Gard |
First Address | Glenside, PA 19038-4812 |
Second Address | Abington, PA 19001-2610 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 11/08/2005 |
Last Update Date | 12/08/2019 |