| NPI | 1639625205 | 
|---|---|
| Former Name | MOLLIE KATHLEEN GARDNER | 
| Entity Type | Individual | 
| Gender | Female | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 363LP0808X Nurse Practitioner, Psych/Mental Health (Licence: OR 201801169NP-PP) | 
| Additional Taxonomies | 364SP0808X Clinical Nurse Specialist, Psych/Mental Health (Licence: OH APRN.CNP.019504) | 
| 163W00000X Registered Nurse (Licence: OH 350691) | |
| 163W00000X Registered Nurse (Licence: OR 201800505RN) | |
| 363L00000X Nurse Practitioner (Licence: OH APRN.CNP.019504) | |
| Enumeration Date | 2016-09-01 | 
| Last Update Date | 2025-02-28 |