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NPI Code Detail

MEDICARE: SYDNEY GARDNER

MEDICARE:   SYDNEY  GARDNER
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
1363LF0000XFamily Nurse Practitioner12081015-4405UT

General Provider Information

NPI Number : 1952257503
Entity Type Code : Individual
Provider Name (Legal Business Name) : SYDNEY GARDNER
Provider Business Mailing Address
First Line : 715 N 300 W
Second Line :
City : AMERICAN FORK
State : UT
Zip : 84003
Country : US
Telephone Number : 801-227-9862
Fax Number :
Provider Business Practice Location Address
First Line : 1446 S PLEASANT GROVE BLVD
Second Line :
City : PLEASANT GROVE
State : UT
Zip : 84062
Country : US
Telephone Number : 801-785-5100
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/06/2026
Last Update Date : 04/13/2026

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Directions to “ SYDNEY GARDNER ” Practice Location

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