Provider Demographics
NPI:1902277718
Name:GARNER, ANDREW TRAVIS (BA)
Entity Type:Individual
Prefix:MR
First Name:ANDREW
Middle Name:TRAVIS
Last Name:GARNER
Suffix:
Gender:M
Credentials:BA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4773 CAUGHLIN PKWY STE 2
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89519-1012
Mailing Address - Country:US
Mailing Address - Phone:775-677-2216
Mailing Address - Fax:
Practice Address - Street 1:4050 GARDELLA AVE APT 431
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89512-1036
Practice Address - Country:US
Practice Address - Phone:702-581-4320
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2015-10-19
Last Update Date:2015-10-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker