Provider Demographics
NPI:1700606167
Name:GILBERT, NAKIA M (RN)
Entity type:Individual
Prefix:
First Name:NAKIA
Middle Name:M
Last Name:GILBERT
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 CHURCHILL WAY
Mailing Address - Street 2:
Mailing Address - City:NEWINGTON
Mailing Address - State:CT
Mailing Address - Zip Code:06111-4021
Mailing Address - Country:US
Mailing Address - Phone:203-410-1901
Mailing Address - Fax:
Practice Address - Street 1:1209 JOHN FITCH BLVD UNIT 2C
Practice Address - Street 2:
Practice Address - City:SOUTH WINDSOR
Practice Address - State:CT
Practice Address - Zip Code:06074-2483
Practice Address - Country:US
Practice Address - Phone:860-781-5753
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-11
Last Update Date:2024-10-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT188572163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse