Provider Demographics
NPI:1881485373
Name:GARDNER, ARLENA (RN)
Entity type:Individual
Prefix:
First Name:ARLENA
Middle Name:
Last Name:GARDNER
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:ARLENA
Other - Middle Name:
Other - Last Name:BERNOCKIE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:RN
Mailing Address - Street 1:710 ROUTE 20
Mailing Address - Street 2:
Mailing Address - City:CAIRO
Mailing Address - State:NY
Mailing Address - Zip Code:12413-2050
Mailing Address - Country:US
Mailing Address - Phone:518-822-7245
Mailing Address - Fax:
Practice Address - Street 1:71 PROSPECT AVE
Practice Address - Street 2:
Practice Address - City:HUDSON
Practice Address - State:NY
Practice Address - Zip Code:12534-2927
Practice Address - Country:US
Practice Address - Phone:518-828-7601
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-14
Last Update Date:2025-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY508850163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse