Individual
GRETCHEN LYNNE SHULL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
7676 REYNOLDS RD, MENTOR, OH 44060-5110
(440) 283-3015
(440) 283-3010
Mailing address
111 NEW HAMPSHIRE AVE STE 2, PORTSMOUTH, NH 03801-2864
(802) 909-2053
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
50.007682
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
103368190
—
PA
Enumeration date
08/09/2017
Last updated
01/31/2024
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