Tabitha Gardner, APN | |
431 W Liberty St, Wauconda, IL 60084-2452 | |
(847) 526-2151 | |
(847) 526-2017 |
Full Name | Tabitha Gardner |
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Gender | Female |
Speciality | Nurse Practitioner |
Location | 431 W Liberty St, Wauconda, Illinois |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1093254443 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 27517 (Tennessee) | Primary |
363LF0000X | Nurse Practitioner - Family | 209015188 (Illinois) | Secondary |
Entity Name | Drynachan Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1891044657 PECOS PAC ID: 2264718824 Enrollment ID: O20170824001273 |
Mailing Address | Practice Location Address |
---|---|
Tabitha Gardner, APN 1005 Dr Db Todd Jr Blvd, Nashville, TN 37208-3501 Ph: (615) 327-5944 | Tabitha Gardner, APN 431 W Liberty St, Wauconda, IL 60084-2452 Ph: (847) 526-2151 |
Kristine M Redmond, APRN, NP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 431 W Liberty St, Wauconda, IL 60084 Phone: 847-526-2151 Fax: 847-526-2017 | |
Ileana A Schropp, FNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 431 W Liberty St, Wauconda, IL 60084 Phone: 847-526-2151 Fax: 847-526-2017 | |
Mrs. Karen Anne Fermin Violago, NP-C Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 431 W Liberty St, Wauconda, IL 60084 Phone: 847-526-2151 Fax: 847-526-2017 | |
Amy Bonfiglio, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 431 W Liberty St, Wauconda, IL 60084 Phone: 847-526-2151 Fax: 847-526-2017 | |
Corrie Mcmahon, FNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 431 W Liberty St, Wauconda, IL 60084 Phone: 847-526-2151 Fax: 847-526-2017 | |
Michelle Delich, MSN, APRN, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 431 W Liberty St, Wauconda, IL 60084 Phone: 847-526-2151 Fax: 847-526-2017 |