Provider Demographics
NPI:1982190260
Name:ROSSITER, GRETCHEN SUZANNE
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:SUZANNE
Last Name:ROSSITER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:14175 BELLE VALLEY RD
Mailing Address - Street 2:
Mailing Address - City:CALDWELL
Mailing Address - State:OH
Mailing Address - Zip Code:43724-9550
Mailing Address - Country:US
Mailing Address - Phone:740-509-3511
Mailing Address - Fax:
Practice Address - Street 1:945 BETHESDA DR STE 230
Practice Address - Street 2:
Practice Address - City:ZANESVILLE
Practice Address - State:OH
Practice Address - Zip Code:43701-1880
Practice Address - Country:US
Practice Address - Phone:740-586-6888
Practice Address - Fax:740-586-6818
Is Sole Proprietor?:No
Enumeration Date:2018-07-10
Last Update Date:2018-10-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHAPRN.CNP.022928363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily