Healthcare Provider Details

I. General information

NPI: 1952018913
Provider Name (Legal Business Name): SHERIKA ANTIONETTE GARDNER PLMHP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/31/2022
Last Update Date: 08/12/2026
Certification Date: 08/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14108 TREGARON RIDGE AVE APT D
BELLEVUE NE
68123-4822
US

IV. Provider business mailing address

14108 TREGARON RIDGE AVE APT D
BELLEVUE NE
68123-4822
US

V. Phone/Fax

Practice location:
  • Phone: 402-819-7808
  • Fax:
Mailing address:
  • Phone: 402-819-7808
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number13208
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: