Provider Demographics
NPI:1164456414
Name:KORVER, GRETCHEN K (MD)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:K
Last Name:KORVER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:GRETCHEN
Other - Middle Name:
Other - Last Name:KOOT
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:10479 DOUBLE R BLVD
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89521-8905
Mailing Address - Country:US
Mailing Address - Phone:775-850-8600
Mailing Address - Fax:775-850-8665
Practice Address - Street 1:10479 DOUBLE R BLVD
Practice Address - Street 2:
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89521-8905
Practice Address - Country:US
Practice Address - Phone:775-850-8600
Practice Address - Fax:775-850-8665
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2017-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV12323207N00000X, 207NS0135X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
No207NS0135XAllopathic & Osteopathic PhysiciansDermatologyProcedural Dermatology