Provider Demographics
NPI:1336928241
Name:PETERS, GRETCHEN LYNN (MSN, APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:LYNN
Last Name:PETERS
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1944 STATE ROUTE 33 STE 206
Mailing Address - Street 2:
Mailing Address - City:NEPTUNE
Mailing Address - State:NJ
Mailing Address - Zip Code:07753-4863
Mailing Address - Country:US
Mailing Address - Phone:732-774-8282
Mailing Address - Fax:
Practice Address - Street 1:1944 STATE ROUTE 33 STE 206
Practice Address - Street 2:
Practice Address - City:NEPTUNE
Practice Address - State:NJ
Practice Address - Zip Code:07753-4863
Practice Address - Country:US
Practice Address - Phone:732-774-8282
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-09-28
Last Update Date:2023-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ14928600363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily