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General NPI Number Information
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NPI Number | 1033274675
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Entity Type | Individual
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Provider Name | COLLEEN GARDNER CNP
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Gender | Female
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Dates
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Enumeration Date | 12/26/2006
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Last Update Date | 10/14/2025
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Provider Practice Location Address
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Address Line | 5320 OVERBEND TRL
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City | SUWANEE
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State | GA
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Zip | 30024-1785
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Country | US
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Telephone | 404-229-0533
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Fax |
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Provider Business Mailing Address
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Address Line | 5320 OVERBEND TRL
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City | SUWANEE
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State | GA
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Zip | 30024-1785
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Country | US
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Telephone | 404-229-0533
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | RN082384
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License Number State | GA
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