Provider Demographics
NPI:1811419815
Name:WENGER, GRETCHEN MAREA (DNP, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:GRETCHEN
Middle Name:MAREA
Last Name:WENGER
Suffix:
Gender:F
Credentials:DNP, FNP-C
Other - Prefix:MISS
Other - First Name:GRETCHEN
Other - Middle Name:MAREA
Other - Last Name:BALDWIN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1025 SUNRISE DR
Mailing Address - Street 2:
Mailing Address - City:MANCHESTER
Mailing Address - State:IA
Mailing Address - Zip Code:52057-1354
Mailing Address - Country:US
Mailing Address - Phone:563-608-9029
Mailing Address - Fax:
Practice Address - Street 1:1515 DELHI ST
Practice Address - Street 2:
Practice Address - City:DUBUQUE
Practice Address - State:IA
Practice Address - Zip Code:52001-6320
Practice Address - Country:US
Practice Address - Phone:563-557-9111
Practice Address - Fax:563-589-4063
Is Sole Proprietor?:No
Enumeration Date:2017-07-11
Last Update Date:2017-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA123615363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily