Provider Demographics
NPI:1992286413
Name:HAYWARD, GRETCHEN MCSPADDEN (MSN, NP-C)
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:MCSPADDEN
Last Name:HAYWARD
Suffix:
Gender:F
Credentials:MSN, NP-C
Other - Prefix:
Other - First Name:GRETCHEN
Other - Middle Name:J
Other - Last Name:MCSPADDEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5765 CATALPA CT
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-3848
Mailing Address - Country:US
Mailing Address - Phone:770-235-3412
Mailing Address - Fax:
Practice Address - Street 1:5765 CATALPA CT
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-3848
Practice Address - Country:US
Practice Address - Phone:770-235-3412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-23
Last Update Date:2018-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN177206363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily