Individual
MRS. MANDY KAY GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PMHNP-BC
Contact information
Practice address
660 S MOUNT JULIET RD STE 130, MT JULIET, TN 37122-6496
(865) 588-3173
Mailing address
660 S MOUNT JULIET RD STE 130, MT JULIET, TN 37122-6496
(865) 588-3173
Taxonomy
Speciality
Code
Description
License number
State
363LP0808X
Psychiatric/Mental Health Nurse Practitioner
Primary
23090
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
08976882
—
MS
05
—
Q032672
—
TN
Enumeration date
07/31/2017
Last updated
05/17/2024
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