Healthcare Provider Details

I. General information

NPI: 1952257503
Provider Name (Legal Business Name): SYDNEY GARDNER
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/06/2026
Last Update Date: 04/13/2026
Certification Date: 04/13/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1446 S PLEASANT GROVE BLVD
PLEASANT GROVE UT
84062
US

IV. Provider business mailing address

715 N 300 W
AMERICAN FORK UT
84003
US

V. Phone/Fax

Practice location:
  • Phone: 801-785-5100
  • Fax:
Mailing address:
  • Phone: 801-227-9862
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number12081015-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: