Gardner, Geraldine
Gardner, Geraldine is an individual health care provider with primary practice located at 900 Sunset Dr , La Grande OR 97850-1387. She recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as her primary health care specialty. Gardner, Geraldine can be contacted via phone (541) 963-2328.Contact Information
Primary practice address
900 Sunset Dr
La Grande OR 97850-1387
Phone: (541) 963-2328
Fax: (541) 975-5210
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | OP60308505 | Washington |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | DO194314 | Oregon |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 822 | Nevada |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 7383A | Wyoming |
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 20A6134 | California |
Profile Details
| NPI number | 1033101696 |
|---|---|
| LBN Legal business name | Gardner, Geraldine |
| Credentials | Doctor of Osteopathy (DO) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Aug 19th, 2005 |
| Last updated | Aug 13th, 2020 - about 4 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1033101696 | NPPES |
| Wyoming | MEDICAID | 123264900 | |
| Wyoming | MEDICAID | 500769777 | |
| Wyoming | MEDICAID | 2016356 |
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