Provider Demographics
NPI:1245565431
Name:GENT, VICTORIA ASHLEY (RN)
Entity Type:Individual
Prefix:
First Name:VICTORIA
Middle Name:ASHLEY
Last Name:GENT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:VICTORIA
Other - Middle Name:ASHLEY
Other - Last Name:GRAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:120 SOLEDAD LN
Mailing Address - Street 2:
Mailing Address - City:VANCEBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28586-7640
Mailing Address - Country:US
Mailing Address - Phone:252-675-0169
Mailing Address - Fax:
Practice Address - Street 1:120 SOLEDAD LN
Practice Address - Street 2:
Practice Address - City:VANCEBORO
Practice Address - State:NC
Practice Address - Zip Code:28586-7640
Practice Address - Country:US
Practice Address - Phone:252-675-0169
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-10-06
Last Update Date:2009-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC221600163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency