Provider Demographics
NPI:1750909891
Name:GOBER, NANCY (PHARMD)
Entity type:Individual
Prefix:
First Name:NANCY
Middle Name:
Last Name:GOBER
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:NANCY
Other - Middle Name:GOBER
Other - Last Name:BRAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4610 MITCHELL RD
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37664-2126
Mailing Address - Country:US
Mailing Address - Phone:423-367-8200
Mailing Address - Fax:
Practice Address - Street 1:HOLSTON VALLEY MEDICAL CENTER INPATIENT PHARMACY
Practice Address - Street 2:130 W RAVINE
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660
Practice Address - Country:US
Practice Address - Phone:423-224-6850
Practice Address - Fax:423-224-6845
Is Sole Proprietor?:No
Enumeration Date:2020-07-06
Last Update Date:2020-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN9386183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist