MEDICARE: SIERRA LYNN GARDNER WHNP

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
1	363LW0102X	Women's Health Nurse Practitioner	F175860	IA

General Provider Information

NPI Number	:	1609659390
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SIERRA LYNN GARDNER WHNP

Provider Business Mailing Address
First Line	:	1511 W BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43222-1000
Country	:	US
Telephone Number	:	614-222-3525
Fax Number	:

Provider Business Practice Location Address
First Line	:	1511 W BROAD ST
Second Line	:
City	:	COLUMBUS
State	:	OH
Zip	:	43222-1000
Country	:	US
Telephone Number	:	614-222-3525
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/16/2023
Last Update Date	:	04/17/2025

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