Robin Marie Gardner, LPN

Individual provider Active NPI Licensed Practical Nurse · Le Roy, NY

NPI 1306000492 · NPPES record last updated Jul 17, 2008

Key facts

NPI
1306000492
Entity type
Individual (NPI type 1)
Primary specialty
Licensed Practical Nurse 164W00000X
License
249802 (NY)
Practice address
156 Lake St
Front Apt
Le Roy, NY 14482-1029
Phone
(585) 768-9291
NPI assigned
Jul 17, 2008
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
249802NYMDLicensed Practical Nurse

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Licensed Practical Nurse 164W00000X 249802 NY Yes

Addresses

Primary practice location

156 Lake St
Front Apt
Le Roy, NY 14482-1029

Mailing address

156 Lake St
Front Apt
Le Roy, NY 14482-1029
Phone (585) 768-9291

Other providers in Le Roy, NY

All providers in Le Roy, NY · Licensed Practical Nurse in New York

Sources for this page

Verify at the official NPI Registry.