Provider Demographics
NPI:1740487248
Name:GILLEY, DEIDRA GWALTNEY (PHARMD)
Entity type:Individual
Prefix:DR
First Name:DEIDRA
Middle Name:GWALTNEY
Last Name:GILLEY
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:495 BILTMORE AVE
Mailing Address - Street 2:ROOM 152
Mailing Address - City:ASHEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28801-4604
Mailing Address - Country:US
Mailing Address - Phone:828-213-9214
Mailing Address - Fax:828-213-0151
Practice Address - Street 1:495 BILTMORE AVE
Practice Address - Street 2:ROOM 152
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28801-4604
Practice Address - Country:US
Practice Address - Phone:828-213-9214
Practice Address - Fax:828-213-0151
Is Sole Proprietor?:No
Enumeration Date:2007-06-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC148971835P1200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1835P1200XPharmacy Service ProvidersPharmacistPharmacotherapy