Healthcare Provider Details

I. General information

NPI: 1982190260
Provider Name (Legal Business Name): GRETCHEN SUZANNE ROSSITER
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/10/2018
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

945 BETHESDA DR STE 230
ZANESVILLE OH
43701-1880
US

IV. Provider business mailing address

14175 BELLE VALLEY RD
CALDWELL OH
43724-9550
US

V. Phone/Fax

Practice location:
  • Phone: 740-586-6888
  • Fax: 740-586-6818
Mailing address:
  • Phone: 740-509-3511
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberAPRN.CNP.022928
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: