Individual
MICHELLE GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
5905 O ST, LINCOLN, NE 68510-2235
(402) 436-1000
Mailing address
1520 SW 23RD ST, LINCOLN, NE 68522-1451
(913) 522-6583
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
24243
NE
Other
Enumeration date
02/05/2018
Last updated
02/05/2018
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