Individual
GRETCHEN WRISTON GWYNETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1541 KINGS HWY, SHREVEPORT, LA 71103-4228
(318) 626-0000
Mailing address
1541 KINGS HWY, ATTN: PAYOR CREDENTIALING, SHREVEPORT, LA 71103-4228
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
30336
SC
2085R0202X
Diagnostic Radiology Physician
Primary
348581
LA
2085R0202X
Diagnostic Radiology Physician
A78296
CA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00A782960
—
CA
Enumeration date
05/09/2006
Last updated
01/14/2026
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us