| NPI | 1801401112 |
|---|---|
| Former Name | COTENNA D GARDNER |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LG0600X Nurse Practitioner, Gerontology (Licence: GA RN231376) |
| Additional Taxonomies | 363LA2200X Nurse Practitioner, Adult Health (Licence: GA RN231376) |
| Enumeration Date | 2020-09-14 |
| Last Update Date | 2020-09-14 |