Healthcare Provider Details

I. General information

NPI: 1063384253
Provider Name (Legal Business Name): GRETCHEN MARIE BAXENDELL RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

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

III. Provider practice location address

7165 CHURCHLAND ST
PITTSBURGH PA
15206-1217
US

IV. Provider business mailing address

170 E STATION SQUARE DR APT 555
PITTSBURGH PA
15219-1238
US

V. Phone/Fax

Practice location:
  • Phone: 412-864-5084
  • Fax:
Mailing address:
  • Phone: 412-864-5084
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WP0809X
TaxonomyAdult Psychiatric/Mental Health Registered Nurse
License NumberRN514889L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: