Provider Demographics
NPI:1164759502
Name:GARDNER, LEEANNA K (CNP)
Entity Type:Individual
Prefix:
First Name:LEEANNA
Middle Name:K
Last Name:GARDNER
Suffix:
Gender:F
Credentials:CNP
Other - Prefix:
Other - First Name:LEEANNA
Other - Middle Name:
Other - Last Name:KRABILL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 7527
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:OH
Mailing Address - Zip Code:43017-0727
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:7450 HOSPITAL DR STE 290
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:OH
Practice Address - Zip Code:43016-9641
Practice Address - Country:US
Practice Address - Phone:614-566-8883
Practice Address - Fax:614-566-8149
Is Sole Proprietor?:No
Enumeration Date:2009-11-05
Last Update Date:2023-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH10838-NP363LF0000X
OH10838NP363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily