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General NPI Number Information
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NPI Number | 1700861234
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Entity Type | Individual
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Provider Name | MINDI GARDNER CNP
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Gender | Female
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Dates
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Enumeration Date | 12/07/2005
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Last Update Date | 08/02/2011
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Provider Practice Location Address
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Address Line | 4600 MONTGOMERY RD STE 105
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City | CINCINNATI
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State | OH
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Zip | 45212-2697
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Country | US
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Telephone | 513-487-5305
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Fax | 513-487-5317
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Provider Business Mailing Address
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Address Line | 10496 MONTGOMERY RD STE 110
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City | CINCINNATI
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State | OH
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Zip | 45242-5223
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Country | US
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Telephone | 513-791-7572
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Fax | 513-791-8240
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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 | 363LA2200X
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Taxonomy Name | Adult Health Nurse Practitioner
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License Number | 07302-NP
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License Number State | OH
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