Individual
DIANNE RENEE CARTER-GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
APRN
Contact information
Practice address
2360 STONY BROOK DR, LOUISVILLE, KY 40220-4018
(502) 446-5555
(502) 394-3670
Mailing address
PO BOX 776351, CHICAGO, IL 60677-6351
(502) 588-9490
(502) 272-5116
Taxonomy
Speciality
Code
Description
License number
State
363LA2200X
Adult Health Nurse Practitioner
4023P
KY
363LF0000X
Family Nurse Practitioner
Primary
3004023
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78010063
—
KY
Enumeration date
12/13/2005
Last updated
08/22/2024
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