Individual
TERESA GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN, C-NP, CWON
Contact information
Practice address
2500 CANYON RD STE 3, BULLHEAD CITY, AZ 86442-8624
(928) 444-1454
(928) 444-1481
Mailing address
2500 CANYON RD STE 3, BULLHEAD CITY, AZ 86442-8624
(928) 444-1454
(928) 444-1481
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
Primary
70008
OK
Other
Enumeration date
05/19/2019
Last updated
10/21/2020
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