Provider Demographics
NPI:1538645957
Name:CHAN, GRETCHEN (FNP)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:CHAN
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:
Other - Last Name:MUSGRAVE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:375 WHITE PLAINS RD
Mailing Address - Street 2:
Mailing Address - City:EASTCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:10709-2826
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:375 WHITE PLAINS RD
Practice Address - Street 2:
Practice Address - City:EASTCHESTER
Practice Address - State:NY
Practice Address - Zip Code:10709-2826
Practice Address - Country:US
Practice Address - Phone:512-324-4780
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-07-18
Last Update Date:2025-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY354799363LF0000X
PASP032176207Q00000X
IAA167963207Q00000X
CA95024282207Q00000X
AZ278738207Q00000X
NJ26NJ01310400207Q00000X
DCNP200006280207Q00000X
TXAP137862363LF0000X
NV857507207Q00000X
COC-APN-0002065-C-NP207Q00000X
KS53-80701-061207Q00000X
NC5022731207Q00000X
WAAP61350350207Q00000X
CT10824207Q00000X
NE113869207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine