Provider Demographics
NPI:1982266557
Name:CALDWELL, GRETCHEN GUDERIAN (CRNA,DNP)
Entity Type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:GUDERIAN
Last Name:CALDWELL
Suffix:
Gender:F
Credentials:CRNA,DNP
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:ELIZABETH
Other - Last Name:GUDERIAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:622A 1ST ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5410
Mailing Address - Country:US
Mailing Address - Phone:504-481-8086
Mailing Address - Fax:
Practice Address - Street 1:1514 JEFFERSON HWY
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70121-2429
Practice Address - Country:US
Practice Address - Phone:866-624-7637
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-07-03
Last Update Date:2019-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA123427367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered