Provider Demographics
NPI:1861369852
Name:GARDINER, JUDY ANN
Entity type:Individual
Prefix:
First Name:JUDY
Middle Name:ANN
Last Name:GARDINER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1336 E WISCONSIN AVE
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54911-3997
Mailing Address - Country:US
Mailing Address - Phone:920-733-7525
Mailing Address - Fax:920-733-3380
Practice Address - Street 1:1336 E WISCONSIN AVE
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54911-3997
Practice Address - Country:US
Practice Address - Phone:920-733-7525
Practice Address - Fax:920-733-3380
Is Sole Proprietor?:No
Enumeration Date:2025-10-22
Last Update Date:2025-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI2182-60237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist