Gardner, Kenzie
Gardner, Kenzie is an individual health care provider with primary practice located at 5885 S Main St Ste 1 , Clarkston MI 48346-2981. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Family, which is considered as her primary health care specialty. Gardner, Kenzie can be contacted via phone (614) 507-3765.Contact Information
Primary practice address
5885 S Main St Ste 1
Clarkston MI 48346-2981
Phone: (614) 507-3765
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Family | 363LF0000X | 4704335952 | Michigan |
Profile Details
| NPI number | 1720596802 |
|---|---|
| LBN Legal business name | Gardner, Kenzie |
| Credentials | Nurse Practitioner (NP) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 11th, 2018 |
| Last updated | Nov 21st, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1720596802 | NPPES |
| Michigan | Other | 4704335952 | NP LICENSE |
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