Healthcare Provider Details

I. General information

NPI: 1154232429
Provider Name (Legal Business Name): ERIN L GENTRY FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/15/2026
Last Update Date: 09/15/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2333 MCCALLIE AVE
CHATTANOOGA TN
37404-3258
US

IV. Provider business mailing address

9335 WYNDOVER DR
OOLTEWAH TN
37363-8021
US

V. Phone/Fax

Practice location:
  • Phone: 423-802-9738
  • Fax:
Mailing address:
  • Phone: 423-802-9738
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number42826
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: