Provider Demographics
NPI:1932133881
Name:TELFER GENTRY, KARLA KAY (NP)
Entity Type:Individual
Prefix:
First Name:KARLA
Middle Name:KAY
Last Name:TELFER GENTRY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:KARLA
Other - Middle Name:KAY
Other - Last Name:TELFER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:9218 W 280 N
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:IN
Mailing Address - Zip Code:46011-9151
Mailing Address - Country:US
Mailing Address - Phone:765-606-5983
Mailing Address - Fax:
Practice Address - Street 1:MADISON CO. HEALTH DEPT
Practice Address - Street 2:206 E 9TH ST COUNTY GOVERNMENT CENTER ANNEX
Practice Address - City:ANDERSON
Practice Address - State:IN
Practice Address - Zip Code:46016
Practice Address - Country:US
Practice Address - Phone:765-646-9206
Practice Address - Fax:765-646-9208
Is Sole Proprietor?:No
Enumeration Date:2006-07-10
Last Update Date:2023-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN71000836A363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200266680Medicaid
IN71000836BOtherCSR
IN353810BMedicare PIN
IN71000836BOtherCSR