Individual
MRS. MIA GENTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP-C
Contact information
Practice address
645 MCQUEEN SMITH RD N, PRATTVILLE, AL 36066-7268
(334) 361-2121
Mailing address
1365 OLD PARK ROW, MONTGOMERY, AL 36117-4395
(334) 451-1146
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
1-077078
AL
Other
Enumeration date
07/29/2014
Last updated
07/29/2014
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