Provider Demographics
NPI:1316124720
Name:GARDINER, YVETTE ELIZABETH (CRNP)
Entity type:Individual
Prefix:
First Name:YVETTE
Middle Name:ELIZABETH
Last Name:GARDINER
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:
Other - First Name:YVETTE
Other - Middle Name:ELIZABETH
Other - Last Name:CAMPBELL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:426 RIVER OAKS LN
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:AL
Mailing Address - Zip Code:35080-8614
Mailing Address - Country:US
Mailing Address - Phone:205-939-9175
Mailing Address - Fax:205-558-2061
Practice Address - Street 1:1600 7TH AVE S
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35233-1711
Practice Address - Country:US
Practice Address - Phone:205-939-9175
Practice Address - Fax:205-558-2061
Is Sole Proprietor?:No
Enumeration Date:2008-01-28
Last Update Date:2019-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1093106363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics