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NPI Code Detail

MEDICARE: NICOLE GARDNER CNS

MEDICARE: NICOLE GARDNER CNS
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1364S00000XClinical Nurse Specialist221169-30WI

General Provider Information

NPI Number : 1508795584
Entity Type Code : Individual
Provider Name (Legal Business Name) : NICOLE GARDNER CNS
Provider Business Mailing Address
First Line : 600 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53792-0001
Country : US
Telephone Number : 608-504-4220
Fax Number :
Provider Business Practice Location Address
First Line : 600 HIGHLAND AVE
Second Line :
City : MADISON
State : WI
Zip : 53792-0001
Country : US
Telephone Number : 608-504-4220
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/15/2026
Last Update Date : 05/15/2026

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