Veneica Gardner

Individual provider Active NPI Student in an Organized Health Care Education/Training Program · Crestwood, KY

NPI 1982169405 · NPPES record last updated Feb 8, 2019

Key facts

NPI
1982169405
Entity type
Individual (NPI type 1)
Primary specialty
Student in an Organized Health Care Education/Training Program 390200000X
Practice address
9222 Foxtail CT
Crestwood, KY 40014-8509
Phone
(502) 724-3374
NPI assigned
Feb 8, 2019
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

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X
Student in an Organized Health Care Education/Training Program 390200000X Yes

Addresses

Primary practice location

9222 Foxtail CT
Crestwood, KY 40014-8509

Mailing address

9222 Foxtail CT
Crestwood, KY 40014-8509

Other providers in Crestwood, KY

All providers in Crestwood, KY · Student in an Organized Health Care Education/Training Program in Kentucky

Sources for this page

Verify at the official NPI Registry.