Individual
MS. REBECCA A GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
4015 GATEWAY BLVD, STE 2120, NEWBURGH, IN 47630-8925
(812) 842-0907
(812) 464-0536
Mailing address
4015 GATEWAY BLVD, STE 2120, NEWBURGH, IN 47630-8925
(812) 492-5457
(812) 464-4485
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
10001074A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000617297
ANTHEM
IN
Enumeration date
03/03/2009
Last updated
12/04/2015
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