Healthcare Provider Details

I. General information

NPI: 1922277748
Provider Name (Legal Business Name): GRETCHEN D EICHENLAUB RNC, MS, WHNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/26/2008
Last Update Date: 01/03/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5353 REYNOLDS ST SUITE NUMBER 300
SAVANNAH GA
31405-6015
US

IV. Provider business mailing address

5353 REYNOLDS ST SUITE NUMBER 300
SAVANNAH GA
31405-6015
US

V. Phone/Fax

Practice location:
  • Phone: 912-355-4408
  • Fax:
Mailing address:
  • Phone: 912-355-4408
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberRN164522
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: