Provider Demographics
NPI:1922398338
Name:GENTRY, SCHREASE SHANDROCHELE (CNA)
Entity Type:Individual
Prefix:
First Name:SCHREASE
Middle Name:SHANDROCHELE
Last Name:GENTRY
Suffix:
Gender:F
Credentials:CNA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6061 STAGE RD
Mailing Address - Street 2:9B
Mailing Address - City:BARTLETT
Mailing Address - State:TN
Mailing Address - Zip Code:38134-8375
Mailing Address - Country:US
Mailing Address - Phone:901-406-6774
Mailing Address - Fax:
Practice Address - Street 1:6061 STAGE RD
Practice Address - Street 2:9B
Practice Address - City:BARTLETT
Practice Address - State:TN
Practice Address - Zip Code:38134-8375
Practice Address - Country:US
Practice Address - Phone:901-406-6774
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-04-19
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes376K00000XNursing Service Related ProvidersNurse's Aide
No3747A0650XNursing Service Related ProvidersTechnicianAttendant Care Provider
No372600000XNursing Service Related ProvidersAdult Companion
No3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant
No374U00000XNursing Service Related ProvidersHome Health Aide
No376J00000XNursing Service Related ProvidersHomemaker