Gardner, Jan L

Gardner, Jan L is an individual health care provider with primary practice located at 1350 S Hickory St Hrmc/Hospitalist Program, Melbourne FL 32901-3224. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gardner, Jan L can be contacted via phone (321) 434-1771.

Contact Information

Primary practice address
1350 S Hickory St Hrmc/Hospitalist Program Melbourne FL 32901-3224
Phone: (321) 434-1771
Fax: (321) 434-1775
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Family 363LF0000X ARNP 2735082 Florida

Profile Details

NPI number 1124065347
LBN Legal business name Gardner, Jan L
Credentials ARNP
Entity Individual
Sole proprietor 1 No
Enumeration date May 31st, 2006
Last updated May 18th, 2012 - about 12 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1124065347 NPPES
Florida Other Y0694H BLUE CROSS
Florida MEDICAID 307595800 BLUE CROSS

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