Provider Demographics
NPI:1376507129
Name:ZUNKEL, GRETCHEN M (NP)
Entity Type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:M
Last Name:ZUNKEL
Suffix:
Gender:F
Credentials:NP
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Mailing Address - Street 1:825 S 8TH ST STE 300
Mailing Address - Street 2:DAVITA CLINICAL RESEARCH
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55404-1212
Mailing Address - Country:US
Mailing Address - Phone:612-852-7003
Mailing Address - Fax:
Practice Address - Street 1:425 20TH AVE S
Practice Address - Street 2:DAVITA CLINICAL RESEARCH
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55454-4400
Practice Address - Country:US
Practice Address - Phone:612-332-4973
Practice Address - Fax:612-238-3534
Is Sole Proprietor?:No
Enumeration Date:2006-04-17
Last Update Date:2017-01-20
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN1581434363LA2200X, 363LP0808X
MNR1581434364SP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
No363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No364SP0809XPhysician Assistants & Advanced Practice Nursing ProvidersClinical Nurse SpecialistPsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN938108200Medicaid
P91558Medicare UPIN
MN938108200Medicaid