Individual
MS. GRETCHEN JILLIAN NITZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
919 E CENTRAL AVE STE 102, LA FOLLETTE, TN 37766-2778
(423) 907-1740
(423) 907-1743
Mailing address
151 FRANK L DIGGS DR, CLINTON, TN 37716-6953
(865) 647-3320
(865) 647-3329
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
119
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3665540
—
TN
Enumeration date
10/26/2005
Last updated
03/09/2022
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