Healthcare Provider Details

I. General information

NPI: 1386797090
Provider Name (Legal Business Name): GRETCHEN A. LAWRENCE DPM
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/18/2007
Last Update Date: 09/03/2025
Certification Date: 09/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1322 W MAIN ST
FOREST CITY NC
28043-2555
US

IV. Provider business mailing address

1322 W MAIN ST
FOREST CITY NC
28043-2555
US

V. Phone/Fax

Practice location:
  • Phone: 828-245-1111
  • Fax: 828-516-9376
Mailing address:
  • Phone: 828-245-1111
  • Fax: 828-516-9376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213ES0131X
TaxonomyFoot Surgery Podiatrist
License Number547
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code213EP1101X
TaxonomyPrimary Podiatric Medicine Podiatrist
License Number547
License Number StateNC
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number547
License Number StateNC
# 4
Primary TaxonomyN
Taxonomy Code213ES0103X
TaxonomyFoot & Ankle Surgery Podiatrist
License Number547
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: