K a Gardner PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP129382 Issued in TX

Legal business name

K A GARDNER PLLC

Practice address

3109 6TH Ave Ste B
Fort Worth, TX 76110-3800

Phone

(682) 312-7339

NPI assigned

Dec 5, 2015

Organization subpart

No

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

Authorized official

Name

Kimberley Gardner, PMHNP

Title

Owner/Provider

Phone

(817) 269-1169

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1449273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1449273600000",
    "number": "1609241488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1210 POWDER RIVER TRL",
            "city": "SOUTHLAKE",
            "state": "TX",
            "postal_code": "760923231"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3109 6TH AVE STE B",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761103800",
            "telephone_number": "682-312-7339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "K A GARDNER PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-05",
        "last_updated": "2015-12-05",
        "status": "A",
        "authorized_official_last_name": "GARDNER",
        "authorized_official_first_name": "KIMBERLEY",
        "authorized_official_title_or_position": "OWNER/PROVIDER",
        "authorized_official_telephone_number": "817-269-1169",
        "authorized_official_credential": "PMHNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "TX",
            "license": "AP129382",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Psychiatric/Mental Health Nurse Practitioner in Fort Worth, TX
• Providers in Fort Worth, TX by specialty
• Psychiatric/Mental Health Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2015; 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.