Active NPI
Carolyn Gardner, LVN
- Licensed Vocational Nurse
- Harker Heights, TX
National Provider Identifier
1053923615
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Vocational Nurse
- License
- 90417
- Practice address
- 303 Grizzly TRL
Harker Heights, TX 76548-5628 - Phone
- (254) 252-5757
- NPI assigned
- Aug 17, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Licensed Vocational Nurse | 164X00000X | 90417 | TX | Primary |
Addresses
Primary practice location
303 Grizzly TRL
Harker Heights, TX 76548-5628
Mailing address
303 Grizzly TRL
Harker Heights, TX 76548-5628
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 90417 | TX | MD | Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1597622400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1597622400000",
"number": "1053923615",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "303 GRIZZLY TRL",
"city": "HARKER HEIGHTS",
"state": "TX",
"postal_code": "765485628"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "303 GRIZZLY TRL",
"city": "HARKER HEIGHTS",
"state": "TX",
"postal_code": "765485628",
"telephone_number": "254-252-5757"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GARDNER",
"first_name": "CAROLYN",
"credential": "LVN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-08-17",
"last_updated": "2020-08-17",
"certification_date": "2020-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "164X00000X",
"taxonomy_group": "",
"desc": "Licensed Vocational Nurse",
"state": "TX",
"license": "90417",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Harker Heights, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.