Provider Demographics
NPI:1679724876
Name:GILBERT, NICOLE NOEL (PT)
Entity Type:Individual
Prefix:
First Name:NICOLE
Middle Name:NOEL
Last Name:GILBERT
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2804 SHELBURNE FALLS RD
Mailing Address - Street 2:
Mailing Address - City:HINESBURG
Mailing Address - State:VT
Mailing Address - Zip Code:05461-9782
Mailing Address - Country:US
Mailing Address - Phone:802-482-5675
Mailing Address - Fax:
Practice Address - Street 1:2804 SHELBURNE FALLS RD
Practice Address - Street 2:
Practice Address - City:HINESBURG
Practice Address - State:VT
Practice Address - Zip Code:05461-9782
Practice Address - Country:US
Practice Address - Phone:802-482-5675
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-10-06
Last Update Date:2008-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT0400002667225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist