Provider Demographics
NPI:1154647972
Name:MATTE, GRETCHEN JOY (RN)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:JOY
Last Name:MATTE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19 CRESCENT HL
Mailing Address - Street 2:
Mailing Address - City:EAST LONGMEADOW
Mailing Address - State:MA
Mailing Address - Zip Code:01028-2806
Mailing Address - Country:US
Mailing Address - Phone:413-525-0934
Mailing Address - Fax:
Practice Address - Street 1:25 BOND ST
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:MA
Practice Address - Zip Code:01104-3401
Practice Address - Country:US
Practice Address - Phone:413-731-6000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-19
Last Update Date:2010-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA229655163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health