| NPI | 1144605866 |
|---|---|
| Former Name | HALEY BROOKE GENTRY |
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: AL 1-131542) |
| Additional Taxonomies | 363L00000X Nurse Practitioner (Licence: AL 1-131542) |
| Enumeration Date | 2015-07-23 |
| Last Update Date | 2015-07-23 |