Individual
VIRGINIA POOLE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
1190 N STATE ST STE 202, JACKSON, MS 39202-2463
(601) 968-0896
Mailing address
1190 N STATE ST STE 202, JACKSON, MS 39202-2463
(601) 968-0896
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
902817
MS
Other
Enumeration date
07/21/2021
Last updated
08/16/2021
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