BRIAN ROSS GARDNER APRN NPI 1205403565

NPI Information

NPI: 1205403565
Provider Name: BRIAN ROSS GARDNER, APRN
Classification: Nurse Practitioner - 363LA2100X
Entity Type: Individual

Specialization: Acute Care

PECOS Registration: Yes

Address:
1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL
ZIP 32207
Phone: (904) 253-6910
Get Directions

Brian Ross Gardner, APRN is an acute care nurse practitioner in Jacksonville, FL with 4 years of experience. Brian Ross Gardner, APRN NPI is 1205403565. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

1325 SAN MARCO BLVD STE 300
JACKSONVILLE, FL
ZIP 32207-567
Phone: (904) 253-6910
Fax: (904) 253-6964

The NPI 1205403565 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 6/7/2021 and was last updated on 9/12/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	363LA2100X	Nurse Practitioner	Acute Care	APRN11013517	FLORIDA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	111345400	MEDICAID	FLORIDA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

NPI Synchronization or Removal

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