Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Mary Judith Gardner, NP

Individual provider Gerontology Nurse Practitioner · NPI 1033791843

Mary Judith Gardner, NP is a Nurse Practitioner in Grand Rapids, Michigan. Qualified in 2021, 5 years ago. Practices with Ronald Vanderlaan, MD, PLLC, a 3-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Michigan.

Years since qualifying
5
Licensed in
MI
In the registry since
2021
What do these letters mean?
NP — Nurse Practitioner
An advanced practice nurse who can diagnose, treat and in most states prescribe.

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Practice location Address checks out

655 Kenmoor Ave SE Ste 101
Grand Rapids, MI 49546-8622
Phone: (616) 900-9911
Fax: (616) 900-9862
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Gerontology Nurse Practitioner (primary) Taxonomy 363LG0600X · Licence 4704281984 (MI)

Record details

NPI number1033791843
Entity typeIndividual (Type 1)
GenderFemale
Credentials NP
Sole proprietorNo
NPI enumeratedApril 22, 2021
Last updated in NPPESDecember 6, 2021
Certification dateNovember 2, 2021

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2021 (5 years in practice)
Group practice Ronald Vanderlaan, Md, Pllc — 3 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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