Healthcare Provider Details

I. General information

NPI: 1497676340
Provider Name (Legal Business Name): VANESSA GILBERT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/24/2026
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5900 HILLANDALE DR STE 325
LITHONIA GA
30058-3892
US

IV. Provider business mailing address

5900 HILLANDALE DR STE 325
LITHONIA GA
30058-3892
US

V. Phone/Fax

Practice location:
  • Phone: 678-418-6990
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LW0102X
TaxonomyWomen's Health Nurse Practitioner
License NumberAPRN-NP279333
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: