Provider Demographics
NPI:1366511404
Name:GARDNER, JANICE (RN)
Entity type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:GARDNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1906 HIGHWAY 521 BYP S
Mailing Address - Street 2:BYPASS SOUTH
Mailing Address - City:LANCASTER
Mailing Address - State:SC
Mailing Address - Zip Code:29720-7579
Mailing Address - Country:US
Mailing Address - Phone:803-285-1456
Mailing Address - Fax:803-285-5514
Practice Address - Street 1:225 E MAIN ST
Practice Address - Street 2:STE 300
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29730-4541
Practice Address - Country:US
Practice Address - Phone:803-328-9600
Practice Address - Fax:803-329-7141
Is Sole Proprietor?:No
Enumeration Date:2006-11-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC37448163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse