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General NPI Number Information
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NPI Number | 1780269837
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Entity Type | Individual
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Provider Name | GENTRY DANIELLE CATER NP
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Gender | Female
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Dates
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Enumeration Date | 03/10/2021
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Last Update Date | 06/12/2023
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Provider Practice Location Address
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Address Line | 235 E WASHINGTON AVE
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City | ASHBURN
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State | GA
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Zip | 31714-5224
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Country | US
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Telephone | 229-484-2300
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Fax |
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Provider Business Mailing Address
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Address Line | 7011 CONOLY WAY
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City | TIFTON
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State | GA
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Zip | 31794-1952
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Country | US
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Telephone | 229-392-1342
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Fax |
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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 | 363LF0000X
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Taxonomy Name | Family Nurse Practitioner
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License Number | RN248334
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License Number State | GA
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