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General NPI Number Information
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NPI Number | 1790066686
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Entity Type | Individual
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Provider Name | GRETCHEN MELBURG FNP
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Gender | Female
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Dates
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Enumeration Date | 09/06/2011
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Last Update Date | 01/18/2022
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Provider Practice Location Address
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Address Line | 760 CYPRESS AVE STE 110
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City | REDDING
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State | CA
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Zip | 96001-2743
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Country | US
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Telephone | 530-768-9490
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Fax | 650-653-2150
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Provider Business Mailing Address
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Address Line | 300 KNOLLCREST DR
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City | REDDING
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State | CA
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Zip | 96002-0104
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Country | US
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Telephone | 530-768-9490
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Fax | 530-653-2150
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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 | 365787
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License Number State | CA
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