Doctor Name: | LAUREN HOUGHTON GARDNER |
NPI Number: | 1740532043 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ACNP-BC |
License Number: | 5005855 |
Business Practice Address: | 584 Hospital Dr Ne Suite E Bolivia, NC - 284229047 |
Business Phone Number: | 9107545453 |
Business Fax Number: | |
Mailing Address: | Po Box 602484, CHARLOTTE |
State: | NC |
Postal Code: | 282602484 |
Phone Number: | 9107545453 |
Fax Number: | |
NPI Enumeration Date: | 10/10/2012 |
NPI Last Update Date: | 07/15/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2100X |
License Number: | 5005855 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Acute Care |
Taxonomy Definition: |