Provider Demographics
NPI:1063384253
Name:BAXENDELL, GRETCHEN MARIE (RN)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:MARIE
Last Name:BAXENDELL
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:170 E STATION SQUARE DR APT 555
Mailing Address - Street 2:
Mailing Address - City:PITTSBURGH
Mailing Address - State:PA
Mailing Address - Zip Code:15219-1238
Mailing Address - Country:US
Mailing Address - Phone:412-864-5084
Mailing Address - Fax:
Practice Address - Street 1:7165 CHURCHLAND ST
Practice Address - Street 2:
Practice Address - City:PITTSBURGH
Practice Address - State:PA
Practice Address - Zip Code:15206-1217
Practice Address - Country:US
Practice Address - Phone:412-864-5084
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-18
Last Update Date:2025-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PARN514889L163WP0809X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult