Healthcare Provider Details

I. General information

NPI: 1386692200
Provider Name (Legal Business Name): GARDNER VISITING NURSING ASSOCIATION INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/04/2006
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

34 PEARLY LN
GARDNER MA
01440
US

IV. Provider business mailing address

34 PEARLY LN
GARDNER MA
01440
US

V. Phone/Fax

Practice location:
  • Phone: 978-632-1230
  • Fax: 978-632-4513
Mailing address:
  • Phone: 978-632-1230
  • Fax: 978-632-4513

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code251K00000X
TaxonomyPublic Health or Welfare Agency
License Number
License Number StateMA

VIII. Authorized Official

Name: MRS. ELAINE FLUET
Title or Position: CEO
Credential:
Phone: 978-632-1230