Provider Demographics
NPI:1447004163
Name:GILMORE, AALIYAH DOMONIQUE
Entity type:Individual
Prefix:
First Name:AALIYAH
Middle Name:DOMONIQUE
Last Name:GILMORE
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 1:9213 DUKE DR
Mailing Address - Street 2:
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72204-4307
Mailing Address - Country:US
Mailing Address - Phone:501-590-7274
Mailing Address - Fax:
Practice Address - Street 1:9213 DUKE DR
Practice Address - Street 2:
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72204-4307
Practice Address - Country:US
Practice Address - Phone:501-590-7274
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-17
Last Update Date:2025-09-26
Deactivation Date:2025-07-14
Deactivation Code:
Reactivation Date:2025-09-19
Provider Licenses
StateLicense IDTaxonomies
AR374J00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374J00000XNursing Service Related ProvidersDoula