Provider Demographics
NPI:1659099430
Name:WOOLMAN, GRETCHEN NADINE (RN)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:NADINE
Last Name:WOOLMAN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:NADINE
Other - Last Name:STEWART
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9444 BALBOA AVE STE 2000
Mailing Address - Street 2:
Mailing Address - City:SAN DIEGO
Mailing Address - State:CA
Mailing Address - Zip Code:92123-4447
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:5202 UNIVERSITY AVE
Practice Address - Street 2:
Practice Address - City:SAN DIEGO
Practice Address - State:CA
Practice Address - Zip Code:92105-2268
Practice Address - Country:US
Practice Address - Phone:619-229-5400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-08-18
Last Update Date:2022-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95283072163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse