Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2080P0214X | Pediatric Pulmonologist | 01071622A | IN |
Y | 2080P0214X | Pediatric Pulmonologist | 51808 | TN |
NPI | 1063614659 |
---|---|
Provider Name | Dr. Tonia Elizabeth Gardner |
First Address | Memphis, TN 38105-4607 |
Second Address | Memphis, TN 38105-4625 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/06/2007 |
Last Update Date | 02/02/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
Q007625 | (05) | TN |