| Doctor Name: | SHELLY GENTRY |
| NPI Number: | 1770833881 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | RN |
| License Number: | 168050-30 |
| Business Practice Address: | 3241 E Thompson Ave Saint Francis, WI - 532354921 |
| Business Phone Number: | 4147795775 |
| Business Fax Number: | |
| Mailing Address: | 3241 E Thompson Ave, SAINT FRANCIS |
| State: | WI |
| Postal Code: | 532354921 |
| Phone Number: | |
| Fax Number: | |
| NPI Enumeration Date: | 09/17/2012 |
| NPI Last Update Date: | 09/17/2012 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 163WG0000X |
| License Number: | 168050-30 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | WI |
| Taxonomy Type: | Nursing Service Providers |
| Taxonomy Classification: | Registered Nurse |
| Taxonomy Specialization: | General Practice |
| Taxonomy Definition: | |