Individual
KATIE JO GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
1345 UNITY PL STE 235, LAFAYETTE, IN 47905-5761
(765) 446-5065
(765) 446-5170
Mailing address
PO BOX 4699, LAFAYETTE, IN 47903-4699
(765) 449-2732
(765) 449-1196
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
50.002982
OH
363AS0400X
Surgical Physician Assistant
Primary
10001475A
IN
363AS0400X
Surgical Physician Assistant
50.002983
OH
Other
Enumeration date
10/21/2009
Last updated
03/17/2025
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