Individual provider · Type 1 NPI

Katie Jo Gentry, PA

Surgical Physician Assistant · Lafayette, IN

NPI number 1083940308 Active

Practice location

1345 Unity Pl Ste 235
Lafayette, IN 47905-5761

Fax (765) 446-5170

Mailing address

PO Box 4699
Lafayette, IN 47903-4699

Specialties and licenses

TaxonomyCodeLicense
Medical Physician Assistant 363AM0700X50.002982 (OH)
Surgical Physician Assistant 363AS0400X50.002983 (OH)
Surgical Physician Assistant Primary 363AS0400X10001475A (IN)

Surgical Physician Assistant: Definition to come...

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About NPI 1083940308

Katie Jo Gentry, PA's National Provider Identifier is 1083940308, issued on Oct 21, 2009. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Lafayette, IN. The record was last updated on Mar 17, 2025.