Individual
MS. CATES GENTRY GREEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
9430 PARK WEST BLVD STE 130, KNOXVILLE, TN 37923-4205
(865) 690-4486
(865) 560-8525
Mailing address
PO BOX 306556, NASHVILLE, TN 37230-6556
(865) 694-0062
(865) 694-7907
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
2545
TN
363AM0700X
Medical Physician Assistant
1915
SC
363AS0400X
Surgical Physician Assistant
2545
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4935437
AETNA
TN
01
—
6017703
BLUECROSS BLUESHIELD
TN
01
—
6017704
BLUECROSS BLUESHIELD - PA SURGICAL
TN
01
—
P01477134
RR MEDICARE
TN
05
—
Q005835
—
TN
Enumeration date
04/29/2013
Last updated
06/14/2024
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