| NPI | 1427607308 |
|---|---|
| Former Name | CAEDORA MARYLOUISE GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NC 5012193) |
| Additional Taxonomies | 163W00000X Registered Nurse (Licence: NC 264004) |
| 363LF0000X Nurse Practitioner, Family (Licence: VA 0024183725) | |
| Enumeration Date | 2019-09-04 |
| Last Update Date | 2023-08-29 |