Provider Demographics
NPI:1447885603
Name:CARR, GRETCHEN (NP-C)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:CARR
Suffix:
Gender:
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 16149
Mailing Address - Street 2:
Mailing Address - City:RUMFORD
Mailing Address - State:RI
Mailing Address - Zip Code:02916-0697
Mailing Address - Country:US
Mailing Address - Phone:401-453-9625
Mailing Address - Fax:401-435-7069
Practice Address - Street 1:900 DOUGLAS PIKE STE B1
Practice Address - Street 2:
Practice Address - City:SMITHFIELD
Practice Address - State:RI
Practice Address - Zip Code:02917-1842
Practice Address - Country:US
Practice Address - Phone:401-725-4888
Practice Address - Fax:401-725-3336
Is Sole Proprietor?:No
Enumeration Date:2020-03-09
Last Update Date:2025-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIAPRN03108363LF0000X, 363L00000X
IL209020482363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily