Provider Demographics
NPI:1609659390
Name:GARDNER, SIERRA LYNN (WHNP)
Entity type:Individual
Prefix:
First Name:SIERRA
Middle Name:LYNN
Last Name:GARDNER
Suffix:
Gender:F
Credentials:WHNP
Other - Prefix:
Other - First Name:SIERRA
Other - Middle Name:LYNN
Other - Last Name:RICKETTS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1242 DOLEN PL
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52246-4523
Mailing Address - Country:US
Mailing Address - Phone:309-945-3783
Mailing Address - Fax:
Practice Address - Street 1:227 N DUBUQUE ST
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52245-1738
Practice Address - Country:US
Practice Address - Phone:319-337-2111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-16
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAF175860363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health