Gretchen Edstrom, RN, CDE

Primary specialty

Diabetes Educator Registered NurseTaxonomy code 163WD0400X

License

10.R49980 Issued in CT

Practice address

194 Howard St
New London, CT 06320-5544

Phone

(860) 444-3366

Fax

(860) 444-3394

NPI assigned

Sep 4, 2014

Last updated

Sep 4, 2014By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1409788800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409788800000",
    "number": "1497156855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 PAULA LN",
            "city": "WATERFORD",
            "state": "CT",
            "postal_code": "063851521",
            "telephone_number": "860-608-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "194 HOWARD ST",
            "city": "NEW LONDON",
            "state": "CT",
            "postal_code": "063205544",
            "telephone_number": "860-444-3366",
            "fax_number": "860-444-3394"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EDSTROM",
        "first_name": "GRETCHEN",
        "credential": "RN, CDE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-04",
        "last_updated": "2014-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WD0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Diabetes Educator",
            "state": "CT",
            "license": "10.R49980",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Elena Dykas, LMSW
• Joann M Eaccarino, APRN
• East Lyme Caregivers Caregivers
• Eastern Connecticut Surgical Care
• Eastern Shore Chiropractic Center, L.L.C.
• Edward McDermott MD
• Edward McDermott, MD
• Owen Ehrlich, M.D.
• Julia Eisenstein
• Asim Ejaz, M.D.

• Diabetes Educator Registered Nurse in New London, CT
• Providers in New London, CT by specialty
• Diabetes Educator Registered Nurse in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.