Provider Demographics
NPI:1457827354
Name:AMRIEN, GRETCHEN (PA-C)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:AMRIEN
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 BYPASS RD STE 201
Mailing Address - Street 2:
Mailing Address - City:SALEM
Mailing Address - State:NJ
Mailing Address - Zip Code:08079-2053
Mailing Address - Country:US
Mailing Address - Phone:856-935-0066
Mailing Address - Fax:
Practice Address - Street 1:4 BYPASS RD STE 201
Practice Address - Street 2:
Practice Address - City:SALEM
Practice Address - State:NJ
Practice Address - Zip Code:08079-2053
Practice Address - Country:US
Practice Address - Phone:856-935-0066
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-17
Last Update Date:2018-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant