| Provider / Organization | NPI | Date Certified |
|---|---|---|
| CAROLYN ANN GENTLES | 1588654792 | 2024-07-07 |
Carolyn A Gentles [F] graduated in 2000 and primarily specializes in Nurse Practitioner.
Carolyn Ann Gentles is registered with the National Plan and Provider Enumeration System and has been issued an National Provider Identifier (NPI) of 1588654792. Registration indicates Carolyn Ann Gentles is a provider of access to adult/geriatric primary care providers services with a specialization in Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner Access to Pediatric Primary Care Providers (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Physician Assistants & Advanced Practice Nursing Providers, Nurse Practitioner) (Nurse Practitioner: Family, ) (All Other Specialties & Provider Types, ) (Nurse Practitioner Family, Physician Assistants & Advanced Practice Nursing Providers) (Nurse Practitioner, )
| PECOS ID | 5294820841 |
| Registration | PART-B:Y DME:Y HHA:Y PMD:Y |
| Entity Type | Individual |
| Provider Name | Ms. Carolyn Ann Gentles FNP |
| Other Provider Name | Ms. Ann Gentles |
| Practice Office Address | 2145 HENRY TECKLENBURG DR STE 100 CHARLESTON, SC US |
| Practice Office Telephone | 8435560036 |
| Mailing Address | PO BOX 751649 CHARLOTTE, NC 282751649 US |
| Business Telephone | 8884720043 |
| Address | City / State | Phone / Fax |
|---|---|---|
| 171 Ashley Ave | Charleston, SC 294251152 | 8437921414 |
| 340 Kennestone Hospital Blvd Ste 100 | Marietta, GA 30060 | 7702815100 / 6785817100 |
| Document and CCD Exchange [Patient Care Documents] | [email protected] | Direct |
| Code | Practice | License No State |
|---|---|---|
| 363LF0000X PRIMARY | Access to Adult/Geriatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse PractitionerAccess to Pediatric Primary Care Providers Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner Nurse Practitioner: Family All Other Specialties & Provider Types Nurse Practitioner Family Physician Assistants & Advanced Practice Nursing Providers Nurse Practitioner | 18178
SC |
| NP2993 | MEDICAID | SC |