Provider Demographics
NPI:1194974196
Name:SUESS, GRETCHEN (MSN, FNP)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:SUESS
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3470 BUSKIRK AVE
Mailing Address - Street 2:
Mailing Address - City:PLEASANT HILL
Mailing Address - State:CA
Mailing Address - Zip Code:94523-4316
Mailing Address - Country:US
Mailing Address - Phone:510-520-0031
Mailing Address - Fax:
Practice Address - Street 1:1260 S MAIN ST
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-2288
Practice Address - Country:US
Practice Address - Phone:831-769-9355
Practice Address - Fax:831-754-4955
Is Sole Proprietor?:No
Enumeration Date:2008-09-15
Last Update Date:2017-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CANP17791363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner