Provider Demographics
NPI:1417485574
Name:KAUNE, GRETCHEN ROCHESTER (MSN, FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:ROCHESTER
Last Name:KAUNE
Suffix:
Gender:F
Credentials:MSN, FNP-BC
Other - Prefix:MISS
Other - First Name:GRETCHEN
Other - Middle Name:LOCKMAN
Other - Last Name:ROCHESTER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 743904
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3904
Mailing Address - Country:US
Mailing Address - Phone:803-296-7320
Mailing Address - Fax:803-296-7330
Practice Address - Street 1:1079 DUTCH FORK RD
Practice Address - Street 2:
Practice Address - City:IRMO
Practice Address - State:SC
Practice Address - Zip Code:29063-8725
Practice Address - Country:US
Practice Address - Phone:803-749-8900
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-01
Last Update Date:2018-04-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC20988363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily