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Individual

MEGHAN E GENTRY

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
FNP

Contact information

Practice address
4625 E STIPP RD, BLOOMINGTON, IN 47401-9301
(812) 345-2312
Mailing address
4625 E STIPP RD, BLOOMINGTON, IN 47401-9301
(812) 345-2312

Taxonomy

Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
28195262A
IN
363LF0000X
Family Nurse Practitioner
Primary
71014077A
IN

Other

Enumeration date
03/07/2023
Last updated
08/29/2023
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