Provider Demographics
NPI:1689007981
Name:GENTRY, EMILY PAGE (FNP-BC)
Entity Type:Individual
Prefix:MRS
First Name:EMILY
Middle Name:PAGE
Last Name:GENTRY
Suffix:
Gender:F
Credentials:FNP-BC
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Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1275 DICK LONAS RD UNIT 101
Mailing Address - Street 2:
Mailing Address - City:KNOXVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37909-1383
Mailing Address - Country:US
Mailing Address - Phone:865-584-4747
Mailing Address - Fax:865-381-1509
Practice Address - Street 1:128 N WHITNEY AVE
Practice Address - Street 2:
Practice Address - City:COOKEVILLE
Practice Address - State:TN
Practice Address - Zip Code:38501-2493
Practice Address - Country:US
Practice Address - Phone:931-783-4600
Practice Address - Fax:931-783-4699
Is Sole Proprietor?:No
Enumeration Date:2013-08-10
Last Update Date:2024-03-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN17847363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN7100421060Medicaid
TN6002202OtherBCBS
TN1532477Medicaid
TN7100421060Medicaid