Provider Demographics
NPI:1780385336
Name:GUGGENHEIM, GRETCHEN (CNM, WHNP-BC)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:GUGGENHEIM
Suffix:
Gender:
Credentials:CNM, WHNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 CHESLEY CT
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27514-1462
Mailing Address - Country:US
Mailing Address - Phone:864-787-7156
Mailing Address - Fax:
Practice Address - Street 1:4551 NEW BERN AVE
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27610-1551
Practice Address - Country:US
Practice Address - Phone:919-556-1008
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-03-10
Last Update Date:2025-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC104205676363LW0102X
367A00000X
NC5017899363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's HealthGroup - Multi-Specialty
No367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice MidwifeGroup - Multi-Specialty