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General NPI Number Information
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NPI Number | 1245282128
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Entity Type | Individual
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Provider Name | LINDA ANN GARDNER APRN
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Gender | Female
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Dates
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Enumeration Date | 05/17/2006
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Last Update Date | 11/11/2021
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Provider Practice Location Address
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Address Line | 38883 CA HWY 299
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City | WILLOW CREEK
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State | CA
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Zip | 95573-0726
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Country | US
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Telephone | 530-629-3111
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Fax | 530-629-3122
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Provider Business Mailing Address
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Address Line | 1275 8TH STREET
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City | ARCATA
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State | CA
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Zip | 95521
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Country | US
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Telephone | 707-826-8633
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Fax | 707-826-8638
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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 | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 45010
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License Number State | KS
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 95016754
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License Number State | CA
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