Provider Demographics
NPI:1457813412
Name:GILL, VANESSA
Entity Type:Individual
Prefix:
First Name:VANESSA
Middle Name:
Last Name:GILL
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 1:916 STATE ST.,
Mailing Address - Street 2:SAME AS ABOUVE
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36603
Mailing Address - Country:US
Mailing Address - Phone:251-490-0482
Mailing Address - Fax:251-433-8524
Practice Address - Street 1:916 STATE ST.
Practice Address - Street 2:SAME AS ABOVE
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36603
Practice Address - Country:US
Practice Address - Phone:251-490-0482
Practice Address - Fax:251-433-8524
Is Sole Proprietor?:Yes
Enumeration Date:2019-04-01
Last Update Date:2019-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health