Gardner, Michelle Ann
Gardner, Michelle Ann is an individual health care provider with primary practice located at 808 Wacker Dr , Dubuque IA 52002. She recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as her primary health care specialty. Gardner, Michelle Ann can be contacted via phone (563) 557-1133.Contact Information
Primary practice address
808 Wacker Dr
Dubuque IA 52002
Phone: (563) 557-1133
Fax: (563) 557-3022
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Eye and Vision Services Providers / Optometrist | 152W00000X | 02281 | Iowa |
| Eye and Vision Services Providers / Optometrist | 152W00000X | Illinois |
Profile Details
| NPI number | 1639383599 |
|---|---|
| LBN Legal business name | Gardner, Michelle Ann |
| Credentials | Doctor of Optometry (OD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | May 10th, 2007 |
| Last updated | Jul 8th, 2007 - about 18 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 | 1639383599 | NPPES |
| Iowa | MEDICAID | 0425991 | |
| Iowa | Other | 819247 | |
| Iowa | Other | 36582 |
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