Provider Demographics
NPI:1881824662
Name:JONES, GRETCHEN G (RN,BSN,MSN,WHNP-BC)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:G
Last Name:JONES
Suffix:
Gender:F
Credentials:RN,BSN,MSN,WHNP-BC
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:G
Other - Last Name:GIBBS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:828 HEALTHY WAY
Mailing Address - Street 2:SUITE 330
Mailing Address - City:VIRGINIA BEACH
Mailing Address - State:VA
Mailing Address - Zip Code:23462-7958
Mailing Address - Country:US
Mailing Address - Phone:757-461-3890
Mailing Address - Fax:757-467-0301
Practice Address - Street 1:828 HEALTHY WAY
Practice Address - Street 2:SUITE 330
Practice Address - City:VIRGINIA BEACH
Practice Address - State:VA
Practice Address - Zip Code:23462-7958
Practice Address - Country:US
Practice Address - Phone:757-461-3890
Practice Address - Fax:757-459-2658
Is Sole Proprietor?:No
Enumeration Date:2009-07-15
Last Update Date:2015-06-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024168379367A00000X, 363LW0102X
OHION104344591176B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
No176B00000XOther Service ProvidersMidwife
No363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0024168379OtherLICENSE