Provider Demographics
NPI:1720283450
Name:FARMER, GRETCHEN ELIZABETH (MD)
Entity type:Individual
Prefix:DR
First Name:GRETCHEN
Middle Name:ELIZABETH
Last Name:FARMER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:ELIZABETH
Other - Last Name:KLUESNER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1935 PRAIRIE DELL RD STE 400
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:MO
Mailing Address - Zip Code:63084-4327
Mailing Address - Country:US
Mailing Address - Phone:636-649-3085
Mailing Address - Fax:636-649-3086
Practice Address - Street 1:1935 PRAIRIE DELL RD STE 400
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:MO
Practice Address - Zip Code:63084-4327
Practice Address - Country:US
Practice Address - Phone:636-649-3085
Practice Address - Fax:636-649-3087
Is Sole Proprietor?:No
Enumeration Date:2007-06-21
Last Update Date:2024-06-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2007005528208000000X, 207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No208000000XAllopathic & Osteopathic PhysiciansPediatrics