TINA FAITH GENTRY (NPI# 1730118365) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730118365 |
| Entity Type | Individual |
| Full Name | TINA FAITH GENTRY |
| Credential | PA |
| Practice Address |
7925 Youree Dr Suite 280b Shreveport LA 71105-5538 |
| Practice Telephone | 3182123636 |
| Practice Fax Number | 3182123649 |
| Enumeration Date | 2006-07-03 |
| Last Update Date | 2008-04-14 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
PAA10432 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
A10432 | LA | Physician Assistants & Advanced Practice Nursing Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| LA | 1722901 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104906775 | Tina C Gentry | Licensed Practical Nurse | 510 Cumberland St, Executive Plaza 4th Fl, Bristol, VA 24201 | 2006-10-17 |
| Street Address |
7925 YOUREE DR SUITE 280B |
| City | SHREVEPORT |
| State | LA |
| Zip Code | 71105-5538 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1699245928 | Misty Johnetta Ross | Counselor | 2942 Knight St., Bldg. 4 Suite 426, Shreveport, LA 71105 | 2018-11-29 |
| 1205301868 | Tatjhana Maury | Case Manager/Care Coordinator | 3325 Youree Drive, Shreveport, LA 71105 | 2018-10-10 |
| 1245710920 | Jefferey Douglas Adair Md | Non-Pharmacy Dispensing Site | 8860 Fern Ave., Suite 120, Shreveport, LA 71105 | 2018-08-21 |
| 1679059539 | Michael E Woolbert Dds LLC | Dentist | 7600 Fern Avenue, Building 1100, Shreveport, LA 71105 | 2018-07-13 |
| 1881195675 | Adiba Bibi | Pharmacist | 3555 Greenwood Road, Walgreens, Shreveport, LA 71105 | 2018-02-27 |
| 1740796655 | Allison Borel | Counselor | 2020 E 70th St Ste 201, Shreveport, LA 71105 | 2017-12-15 |
| 1073028148 | Valerie Wooten Barcelona | Physical Therapist | 130 Kayla Street, Shreveport, LA 71105 | 2017-12-11 |
| 1710497615 | Jimmy Carroll | Counselor | 2960 Knight St, Suite 110, Shreveport, LA 71105 | 2017-10-05 |
| 1932618444 | David Louis Bennett | Counselor | 3007 Knight St., Suite 200, Shreveport, LA 71105 | 2017-09-27 |
| 1619496452 | Shaqwana Hodge | Counselor | 2920 Knight St. Suite 110, Shreveport, LA 71105 | 2017-09-13 |
| Find all providers in zip 71105 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790228013 | Brian Keith Fontenot | Physician Assistant | 2751 Albert L Bicknell Dr Ste 5c, Shreveport, LA 71103-3943 | 2016-11-18 |
| 1831412626 | Christopher Micheal Magill | Physician Assistant | 2551 Greenwood Rd Ste 210, Shreveport, LA 71103-3985 | 2010-03-08 |
| 1851401426 | Teresa Bigler | Physician Assistant | 1606 Kings Hwy, Shreveport, LA 71103-4128 | 2006-08-30 |
| 1487616538 | David Stanley Staton | Physician Assistant | Overton Brooks Vamc, 510 East Stoner Ave, Shreveport, LA 71101 | 2006-04-04 |
| 1114924404 | Mary Mcferren | Physician Assistant | 1455 E Bert Kouns Industrial Loop # 200, Shreveport, LA 71105 | 2005-07-01 |
| 1487252029 | Melissa Raney | Physician Assistant | 2709 Mackey Ln, Shreveport, LA 71118-2556 | 2020-10-15 |
| 1629683230 | Amanda Renae Simmons | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-09-10 |
| 1700496312 | Caroline Leigh Harris | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2020-08-07 |
| 1811459449 | Lyndsey Pate Day | Physician Assistant | 1541 Kings Hwy, Shreveport, LA 71103-4228 | 2019-04-02 |
| 1497139695 | Amanda Barnes | Physician Assistant | 7045 Youree Dr, Shreveport, LA 71105-5108 | 2015-07-17 |
| Find all providers in SHREVEPORT | ||||
| City | SHREVEPORT |
| Zip Code | 71105 |
Please comment or provide details below to improve the information on TINA FAITH GENTRY.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.