Individual
VIRGINIA GENTRY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
BSN, RN
Contact information
Practice address
6212 TIMBERWOLFE DR, GLEN CARBON, IL 62034-1388
(314) 805-3703
Mailing address
6212 TIMBERWOLFE DR, GLEN CARBON, IL 62034-1388
(314) 805-3703
Taxonomy
Speciality
Code
Description
License number
State
163WG0000X
General Practice Registered Nurse
Primary
041.536654
IL
Other
Enumeration date
05/19/2026
Last updated
05/19/2026
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