Provider Demographics
NPI:1285524025
Name:GWARTNEY, AIDAN IRENE
Entity type:Individual
Prefix:MS
First Name:AIDAN
Middle Name:IRENE
Last Name:GWARTNEY
Suffix:
Gender:F
Credentials:
Other - Prefix:MS
Other - First Name:NADIA
Other - Middle Name:IRENE
Other - Last Name:GWARTNEY
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:716 N NILES AVE APT 1014
Mailing Address - Street 2:
Mailing Address - City:SOUTH BEND
Mailing Address - State:IN
Mailing Address - Zip Code:46617-1973
Mailing Address - Country:US
Mailing Address - Phone:260-920-8071
Mailing Address - Fax:
Practice Address - Street 1:1234 N NOTRE DAME AVE
Practice Address - Street 2:
Practice Address - City:SOUTH BEND
Practice Address - State:IN
Practice Address - Zip Code:46617-1404
Practice Address - Country:US
Practice Address - Phone:574-631-5574
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-07-03
Last Update Date:2025-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program