Provider Demographics
NPI:1811363641
Name:PERRY-EMERY, GRETCHEN
Entity type:Individual
Prefix:
First Name:GRETCHEN
Middle Name:
Last Name:PERRY-EMERY
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2525 S TELEGRAPH RD STE 305
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48302-0287
Mailing Address - Country:US
Mailing Address - Phone:248-601-0234
Mailing Address - Fax:844-273-8145
Practice Address - Street 1:2525 S TELEGRAPH RD STE 305
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48302-0287
Practice Address - Country:US
Practice Address - Phone:248-601-0234
Practice Address - Fax:844-273-8145
Is Sole Proprietor?:No
Enumeration Date:2015-08-17
Last Update Date:2025-09-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704196031363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4704196031Medicare PIN