Jennifer L Gardner, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

312658-31 Issued in WI

Practice address

713 Mather St
Green Bay, WI 54303-3559

Phone

(920) 309-1486

NPI assigned

Apr 12, 2012

Last updated

May 21, 2012By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1334188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1337558400000",
    "number": "1548527740",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "713 MATHER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033559",
            "telephone_number": "920-309-1486"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "713 MATHER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543033559",
            "telephone_number": "920-309-1486"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "JENNIFER",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-04-12",
        "last_updated": "2012-05-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "WI",
            "license": "291818",
            "primary": false
        },
        {
            "code": "376K00000X",
            "taxonomy_group": "",
            "desc": "Nurse's Aide",
            "state": "WI",
            "license": "291818",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "312658-31",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter V Gapinski, MD
• Rene Garcia, CRNA
• Angela Gardebrecht
• Celia J Gardner, LPC
• Gregory S Gardner, D.D.S.
• Kristin Marie Gardon, NP
• Mark A Gardon, MD
• Margaret Garot, RD
• Jennifer Garrison, FNP-C, APNP
• Christine A. Garstka, PSYD, LPC

• Licensed Practical Nurse in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Licensed Practical Nurse in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.