Juanita Ann Gardner, PA-C
Physician Assistant in Philadelphia, PA. Individual provider (NPI-1).
NPI number1679907802
StatusActive
Last updated in NPPESAug 23, 2013
Details
- NPI
- 1679907802
- Entity type
- Individual (NPI-1)
- Name
- Miss Juanita Ann Gardner
- Credential
- PA-C
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Aug 23, 2013
- Last updated
- Aug 23, 2013
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 363A00000X | Physician Assistant | MA001936L | PA | Yes |
Practice location
1505 Race StMail Stop 503
Philadelphia, PA 19102-1119
Phone 215-762-3083 · Fax 215-762-1164
Mailing address
1505 Race StMail Stop 503
Philadelphia, PA 19102-1119
Phone 215-762-3083 · Fax 215-762-1164
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