Healthcare Provider Details

I. General information

NPI: 1912229212
Provider Name (Legal Business Name): SHEILA ANN GENT NP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2010
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4501 EMPIRE CT
FREDERICKSBURG VA
22408-1949
US

IV. Provider business mailing address

4501 EMPIRE CT
FREDERICKSBURG VA
22408-1949
US

V. Phone/Fax

Practice location:
  • Phone: 540-371-0079
  • Fax:
Mailing address:
  • Phone: 540-371-0079
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number0024168514
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: