Basic Information
| Provider Information | |||||||||
| NPI: | 1134476625 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | GARDNER | ||||||||
| FirstName: | LINDA | ||||||||
| MiddleName: | RAE | ||||||||
| NamePrefix: | MISS | ||||||||
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| Credential: | NP | ||||||||
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| Mailing Information | |||||||||
| Address1: | 825 WILLS RD | ||||||||
| Address2: | |||||||||
| City: | CONNELLSVILLE | ||||||||
| State: | PA | ||||||||
| PostalCode: | 154254251 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4125823491 | ||||||||
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| Practice Location | |||||||||
| Address1: | 500 W. BERKELY ST | ||||||||
| Address2: | C/O HOSPITAL CARE ASSOCIATES | ||||||||
| City: | UNIONTOWN | ||||||||
| State: | PA | ||||||||
| PostalCode: | 15401 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7244305000 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 08/14/2012 | ||||||||
| LastUpdateDate: | 08/14/2012 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | SP012068 | PA | Y | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
No ID Information.