Provider Demographics
NPI:1194325035
Name:GILBERT, NATHALIE MONIQUE (PHARMD)
Entity type:Individual
Prefix:
First Name:NATHALIE
Middle Name:MONIQUE
Last Name:GILBERT
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 1:6120 JOHN JACKSON DR
Mailing Address - Street 2:
Mailing Address - City:WILLIAMSBURG
Mailing Address - State:VA
Mailing Address - Zip Code:23188-7606
Mailing Address - Country:US
Mailing Address - Phone:757-874-4722
Mailing Address - Fax:757-874-5166
Practice Address - Street 1:12401 JEFFERSON AVE
Practice Address - Street 2:
Practice Address - City:NEWPORT NEWS
Practice Address - State:VA
Practice Address - Zip Code:23602-4311
Practice Address - Country:US
Practice Address - Phone:757-874-4722
Practice Address - Fax:757-874-5166
Is Sole Proprietor?:Yes
Enumeration Date:2020-10-29
Last Update Date:2020-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0202210119183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist