Provider Demographics
NPI:1265313464
Name:GILLETTE, NAILAH ALNISA
Entity type:Individual
Prefix:
First Name:NAILAH
Middle Name:ALNISA
Last Name:GILLETTE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:9237 DELANCEY LN NW
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28027-3768
Mailing Address - Country:US
Mailing Address - Phone:704-619-0537
Mailing Address - Fax:
Practice Address - Street 1:8825 ARBOR CREEK DR
Practice Address - Street 2:
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28269-0541
Practice Address - Country:US
Practice Address - Phone:704-619-0537
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-09-12
Last Update Date:2025-09-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies