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General NPI Number Information
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NPI Number | 1528006095
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Entity Type | Individual
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Provider Name | GRETCHEN ELENE OLDS RN, APRN, NP-C
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Gender | Female
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Dates
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Enumeration Date | 06/04/2006
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Last Update Date | 06/15/2023
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Provider Practice Location Address
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Address Line | 313 W COUNTRY CLUB RD STE 12
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City | ROSWELL
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State | NM
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Zip | 88201-5804
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Country | US
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Telephone | 575-627-5828
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Fax | 575-627-5835
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Provider Business Mailing Address
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Address Line | 3821 MASTHEAD ST NE
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City | ALBUQUERQUE
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State | NM
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Zip | 87109-4679
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Country | US
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Telephone | 505-998-7400
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Fax | 505-998-7740
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN122840
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | 122840
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License Number State | GA
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Taxonomy #3
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number | 67156
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License Number State | NM
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