Provider Demographics
NPI:1336132109
Name:GAUS, GRETCHEN M (CRNA)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:M
Last Name:GAUS
Suffix:
Gender:F
Credentials:CRNA
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:785 5TH AVENUE
Mailing Address - Street 2:SUITE 3
Mailing Address - City:CHAMBERSBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17201-4232
Mailing Address - Country:US
Mailing Address - Phone:717-263-9555
Mailing Address - Fax:717-217-4217
Practice Address - Street 1:112 NORTH SEVENTH STREET
Practice Address - Street 2:
Practice Address - City:CHAMBERSBURG
Practice Address - State:PA
Practice Address - Zip Code:17201-1720
Practice Address - Country:US
Practice Address - Phone:717-267-3000
Practice Address - Fax:717-217-4217
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-26
Last Update Date:2020-09-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN 264697L367500000X
OHAPRN.CRNA.019932367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA253403OtherUNISON
PA100894308 0001Medicaid
PARN264697LOtherRN LICENSE
PA050514OtherMEDICARE GROUP #
PA25-1716306OtherHEALTHNET/TRICARE
PA120420418OtherDEPT OF LABOR
PA25-1716306OtherFIRST HEALTH
PAPEARLOtherHEALTH AMERICA
PA50073150OtherCAPITAL BLUECROSS
PARN264697LOtherRN LICENSE