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General NPI Number Information
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NPI Number | 1437458650
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Entity Type | Individual
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Provider Name | MRS. ADRIENNE L GENTRY
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Gender | Female
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Dates
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Enumeration Date | 03/28/2011
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Last Update Date | 12/07/2020
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Provider Practice Location Address
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Address Line | 1231 S JEFFERSON ST
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City | ROANOKE
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State | VA
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Zip | 24016-4705
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Country | US
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Telephone | 540-985-8078
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Fax | 540-985-8085
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Provider Business Mailing Address
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Address Line | 1231 S JEFFERSON ST
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City | ROANOKE
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State | VA
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Zip | 24016-4705
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Country | US
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Telephone | 540-985-8078
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Fax | 540-985-8085
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 0102205233
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License Number State | VA
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