Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DERRICKAH TIARAH GARDNER
Deactivated Sole ProprietorDERRICKAH TIARAH GARDNER is a Bus healthcare provider located in RIVERDALE, Georgia. NPI 1548905946 is deactivated in the NPPES registry. Verify at CMS.
Bus · RIVERDALE, GA
This NPI has been deactivated.
The record was deactivated on July 15, 2024.
Deactivated NPIs are no longer valid for billing or credentialing. The provider may have retired, changed practice status, or had their NPI administratively deactivated.
Verify current licensure status with the NPPES NPI Registry or the relevant state medical board before relying on this record.
Registration Details
- NPI Number
- 1548905946
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Apr 29, 2022 (2.2109589041096 yrs)
- Last Updated
- Aug 6, 2024
- Deactivated
- Jul 15, 2024
- Sole Proprietor
- Yes
Practice Information
- Address
-
1161 PINEGLEN DRRIVERDALE, GA, 302963223Browse GA providers · Browse ZIP 30296
- Phone
- 2513823621
- Primary Specialty
-
Bus
343900000X
Other Bus Providers in RIVERDALE, GA
| Name | Credential | NPI |
|---|---|---|
| MR. LEON KING SR. | — | 1184928624 |
| DARRELL TINCH | — | 1023405669 |
| MR. JACKMAN LOUIS LEBLANC JR. | — | 1710662820 |
| MR. JACOB DWAYNE LEWIS | — | 1124874607 |
| ISATOU CEESAY | — | 1609732783 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.