Healthcare Provider Details

I. General information

NPI: 1538052543
Provider Name (Legal Business Name): EMMA GARDNER CNS, LDN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/29/2025
Last Update Date: 05/29/2025
Certification Date: 05/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10770 COLUMBIA PIKE STE 300 #1227
SILVER SPRING MD
20901-4439
US

IV. Provider business mailing address

10770 COLUMBIA PIKE STE 300 #1227
SILVER SPRING MD
20901-4439
US

V. Phone/Fax

Practice location:
  • Phone: 720-550-4204
  • Fax:
Mailing address:
  • Phone: 720-550-4204
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code133N00000X
TaxonomyNutritionist
License NumberDX6930
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: