MEDICARE: MRS. MARY E GARDNER ANP,FNP,CNM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363LF0000X	Family Nurse Practitioner	13138	AK
2	367500000X	Certified Registered Nurse Anesthetist	197700	MT
3	367A00000X	Advanced Practice Midwife	13138	AK
4	363LF0000X	Family Nurse Practitioner	067423	NH

General Provider Information

NPI Number	:	1952484933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. MARY E GARDNER ANP,FNP,CNM

Provider Business Mailing Address
First Line	:	243 ELM ST
Second Line	:
City	:	CLAREMONT
State	:	NH
Zip	:	03743-4921
Country	:	US
Telephone Number	:	907-388-0876
Fax Number	:

Provider Business Practice Location Address
First Line	:	243 ELM ST
Second Line	:
City	:	CLAREMONT
State	:	NH
Zip	:	03743-4921
Country	:	US
Telephone Number	:	603-542-7771
Fax Number	:	603-542-1153

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/23/2006
Last Update Date	:	05/19/2025

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