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Individual
SUSANNA GENTRY
Active
Individual
SUSANNA GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
5013263
NC
363LF0000X
Family Nurse Practitioner
2019045619
NC
363LF0000X
Family Nurse Practitioner
Primary
5013263
NC
Other
Enumeration date
06/30/2020
Last updated
03/13/2025
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