Provider Demographics
NPI:1154961761
Name:GENTRY, KRISTIN MONNIG (PHARMD)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:MONNIG
Last Name:GENTRY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7044 CHARLOTTE PIKE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37209-4210
Mailing Address - Country:US
Mailing Address - Phone:615-352-4386
Mailing Address - Fax:615-352-7871
Practice Address - Street 1:7044 CHARLOTTE PIKE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37209-4210
Practice Address - Country:US
Practice Address - Phone:615-352-4386
Practice Address - Fax:615-352-7871
Is Sole Proprietor?:No
Enumeration Date:2020-01-11
Last Update Date:2020-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2013032789183500000X
NC23395183500000X
OH03233519183500000X
TN0000042953183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist