Individual provider · Type 1 NPI

Shannon L. Gardiner, PA

Surgical Physician Assistant · Meridian, ID

NPI number 1689701260 Active

Practice location

875 S Vanguard Way Ste 200
Meridian, ID 83642-8542

Call (208) 809-2895 Map

Fax (208) 809-2896

Mailing address

PO Box 191050
Boise, ID 83719-1050

Other practice locations

  • 360 E Montvue Dr, Suite 100, Meridian, ID 83642-6318 · (208) 855-2900

Specialties and licenses

TaxonomyCodeLicense
Physician Assistant 363A00000XPA403 (ID)
Surgical Physician Assistant Primary 363AS0400XPA-403 (ID)

Surgical Physician Assistant: Definition to come...

3 other providers at this address

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About NPI 1689701260

Shannon L. Gardiner, PA's National Provider Identifier is 1689701260, issued on Feb 28, 2007. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Meridian, ID. The record was last updated on Apr 24, 2024.