Healthcare Provider Details

I. General information

NPI: 1336595024
Provider Name (Legal Business Name): ANJANETTE GARDNER MSN, APRN, PMHNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2016
Last Update Date: 07/01/2026
Certification Date: 07/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3012 GLENMORE AVE STE 104
CINCINNATI OH
45238-2258
US

IV. Provider business mailing address

9 CHESAPEAKE PLZ
CHESAPEAKE OH
45619-1003
US

V. Phone/Fax

Practice location:
  • Phone: 513-913-1815
  • Fax:
Mailing address:
  • Phone: 740-340-1602
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License NumberAPRN.CNP.0042229
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN. 418779
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: