Individual
MS. SUSAN E GENTRY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP
Contact information
Practice address
44 BROOKLYN JANICE RD, BROOKLYN, MS 39425-9731
(601) 582-1188
(601) 582-8844
Mailing address
PO BOX 1729, HATTIESBURG, MS 39403-1729
(601) 545-8700
(601) 450-0231
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
R852221
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06335619
—
MS
Enumeration date
04/18/2008
Last updated
03/19/2024
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