Individual provider Active NPI

Nyla Rae Gardner, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Portsmouth, NH
National Provider Identifier
1639412703
Registry record updated Jun 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
036181-23 Issued in NH
Practice address
100 Eileen Dondero Foley Ave Ste 302
Portsmouth, NH 03801-4597
Phone
(603) 883-0005
Fax
(603) 883-0007
NPI assigned
Mar 27, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 16, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 036181-23 NH Primary

Addresses

Primary practice location

100 Eileen Dondero Foley Ave Ste 302
Portsmouth, NH 03801-4597

Mailing address

4800 N Scottsdale Rd Ste 2500
Suite B2
Scottsdale, AZ 85251-7630
Phone (603) 883-0005

Other practice location 1

80 Nashua Rd
Suite B2
Londonderry, NH 03053-3426
Phone (603) 818-8926

Other names 1

  • Nyla Rae Hickman Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NH
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20141113001557 NH Practitioner - Nurse Practitioner 2860614583 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
The Counseling Center of Nashua IncGroup PAC ID 3274523758, 250 clinicians

Practice addresses (Care Compare)

100 Eileen Dondero Foley Ave
Suite 302
Portsmouth, NH 03801-4597
Phone (603) 883-0005

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
The Counseling Center of Nashua Inc CurrentSince Sep 16, 2025 Accepting new patients

Locations

4800 N Scottsdale Rd
Ste 2500
Scottsdale, AZ 85251
Phone (253) 346-0392

24 Front St
Exeter, NH 03833
Phone (603) 772-3900

100 Eileen Dondero Foley Ave
Ste 302
Portsmouth, NH 03801
Phone (603) 427-6868

Interoperability endpoints

  • Direct secure messaging: lifestancehealth.nylagardner@140126.advancedmd-direct.com

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1364342400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1781568000000",
    "number": "1639412703",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4800 N SCOTTSDALE RD STE 2500",
            "address_2": "SUITE B2",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852517630",
            "telephone_number": "603-883-0005",
            "fax_number": "603-883-0007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 EILEEN DONDERO FOLEY AVE STE 302",
            "city": "PORTSMOUTH",
            "state": "NH",
            "postal_code": "038014597",
            "telephone_number": "603-883-0005",
            "fax_number": "603-883-0007"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "80 Nashua Rd",
            "address_2": "Suite B2",
            "address_purpose": "LOCATION",
            "city": "Londonderry",
            "state": "NH",
            "postal_code": "030533426",
            "country_code": "US",
            "telephone_number": "603-818-8926",
            "fax_number": "603-818-8928",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GARDNER",
        "first_name": "NYLA",
        "middle_name": "RAE",
        "credential": "PMHNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-27",
        "last_updated": "2026-06-16",
        "certification_date": "2026-06-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "NH",
            "license": "036181-23",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NYLA",
            "last_name": "HICKMAN",
            "middle_name": "RAE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Portsmouth, NH

Sources for this page

Verify at the official NPI Registry.