Mr. Gary John Gardner
Nurse Practitioner - Women's Health
4251 Forest Park Ave
Saint Louis
, Missouri 63108-2810
Mr. Gary John Gardner
Nurse Practitioner - Women's Health
4251 Forest Park Ave
Saint Louis
, Missouri 63108-2810
(618) 363-9545
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About
Features
Specialties
- Nurse Practitioner - Women's Health
Languages spoken
- English
Location
First Address
- Mr. Gary John Gardner
- 26 N Pennsylvania Ave
- Belleville, IL
- Zip : 62220-3952
- Phone : (618) 363-9545
Second Address
- Mr. Gary John Gardner
- 4251 Forest Park Ave
- Saint Louis, MO
- Zip : 63108-2810
- Phone : (618) 363-9545
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 363LW0102X | Nurse Practitioner - Women's Health | 209005922 | IL |
National Provider Identifier
| NPI | 1003104993 |
|---|---|
| Provider Name | Mr. Gary John Gardner |
| First Address | Belleville, IL 62220-3952 |
| Second Address | Saint Louis, MO 63108-2810 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 13/07/2011 |
| Last Update Date | 21/08/2012 |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.