Healthcare Provider Details

I. General information

NPI: 1154952182
Provider Name (Legal Business Name): HILDA GENTRY MSN, RN, FNP-BC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/29/2020
Last Update Date: 06/03/2025
Certification Date: 06/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2700 WAYNE MEMORIAL DR
GOLDSBORO NC
27534-9494
US

IV. Provider business mailing address

8200 GREEN LANTERN ST APT 103
RALEIGH NC
27613-4596
US

V. Phone/Fax

Practice location:
  • Phone: 919-736-1110
  • Fax:
Mailing address:
  • Phone: 570-269-0012
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number5012774
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: