Provider Demographics
NPI:1013037076
Name:ALBERT, GRETCHEN LYNN (OD)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:LYNN
Last Name:ALBERT
Suffix:
Gender:F
Credentials:OD
Other - Prefix:MRS
Other - First Name:GRETCHEN
Other - Middle Name:LYNN
Other - Last Name:SPANGLER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:OD
Mailing Address - Street 1:1011 CRANES GAP RD
Mailing Address - Street 2:
Mailing Address - City:CARLISLE
Mailing Address - State:PA
Mailing Address - Zip Code:17013-9676
Mailing Address - Country:US
Mailing Address - Phone:717-249-2596
Mailing Address - Fax:
Practice Address - Street 1:60 NOBLE BLVD
Practice Address - Street 2:
Practice Address - City:CARLISLE
Practice Address - State:PA
Practice Address - Zip Code:17013-4119
Practice Address - Country:US
Practice Address - Phone:717-258-4508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOEG001052152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist