Healthcare Provider Details

I. General information

NPI: 1053514539
Provider Name (Legal Business Name): GRETCHEN BISHOP CRNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GRETCHEN SAELER

II. Dates (important events)

Enumeration Date: 06/11/2007
Last Update Date: 09/28/2021
Certification Date: 09/28/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

160 MEDICAL CENTER RD STE A
CHICORA PA
16025-2612
US

IV. Provider business mailing address

160 MEDICAL CENTER RD STE A
CHICORA PA
16025-2612
US

V. Phone/Fax

Practice location:
  • Phone: 724-445-3561
  • Fax: 724-445-7446
Mailing address:
  • Phone: 724-445-3561
  • Fax: 724-445-7446

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN317745L
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberSP011900
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: