Healthcare Provider Details

I. General information

NPI: 1497757322
Provider Name (Legal Business Name): ANNA M. GARD C.R.N.P.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/11/2005
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1120 MEETINGHOUSE RD
GWYNEDD PA
19436-1000
US

IV. Provider business mailing address

440 ABINGTON AVE
GLENSIDE PA
19038-4812
US

V. Phone/Fax

Practice location:
  • Phone: 215-283-7159
  • Fax:
Mailing address:
  • Phone: 215-886-3461
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LC1500X
TaxonomyCommunity Health Nurse Practitioner
License NumberUP003792-B
License Number StatePA
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberUP003792B
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: