Connie M Gardiner

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

345389 Issued in WI

Practice address

2550 Edgewood Dr
Beloit, WI 53511-7031

Phone

(608) 436-3243

NPI assigned

Mar 9, 2011

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Connie M Gardiner Professional name

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": "1299628800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1299628800000",
    "number": "1871891200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 EDGEWOOD DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535117031",
            "telephone_number": "608-436-3243"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 EDGEWOOD DR",
            "city": "BELOIT",
            "state": "WI",
            "postal_code": "535117031",
            "telephone_number": "608-436-3243"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GARDINER",
        "first_name": "CONNIE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2011-03-09",
        "last_updated": "2011-03-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "WI",
            "license": "345389",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CONNIE",
            "last_name": "GARDINER",
            "middle_name": "M",
            "credential": "L.P.N.",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Leland J From, MD
• Michelle Lea Fulk
• Full 360
• Katrina Nicole Gadsby, MS, OTR/L
• Stacy Lynn Gallagher, LPN
• Nicole Gawlik
• Amy Christine Gentz, MSW LCSW
• Tammy Ann Gestrich, RN
• Christopher C Gianvecchio, MD
• Keith D Gibson, PHD

• Licensed Practical Nurse in Beloit, WI
• Providers in Beloit, 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 Mar 9, 2011; 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.