Provider Demographics
NPI:1235495847
Name:SALZWEDEL, GRETCHEN KAY (RN)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:KAY
Last Name:SALZWEDEL
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 1:2980 RICE STREET
Mailing Address - Street 2:
Mailing Address - City:LITTLE CANADA
Mailing Address - State:MN
Mailing Address - Zip Code:55113
Mailing Address - Country:US
Mailing Address - Phone:651-488-4655
Mailing Address - Fax:651-488-4656
Practice Address - Street 1:2980 RICE STREET
Practice Address - Street 2:
Practice Address - City:LITTLE CANADA
Practice Address - State:MN
Practice Address - Zip Code:55113
Practice Address - Country:US
Practice Address - Phone:651-488-4655
Practice Address - Fax:651-488-4656
Is Sole Proprietor?:No
Enumeration Date:2012-04-09
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR164964-8163WH0200X
WI172266-030163WH0200X
AZRN163616163WH0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WH0200XNursing Service ProvidersRegistered NurseHome Health