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NPI Code Detail

MEDICARE: MS. VIRGINIA N GILBRIDE M.ED.

MEDICARE:  MS. VIRGINIA N GILBRIDE  M.ED.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1171M00000XCase Manager/Care CoordinatorGA

General Provider Information

NPI Number : 1245424373
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. VIRGINIA N GILBRIDE M.ED.
Provider Business Mailing Address
First Line : 5975 LAKE SHORE DR
Second Line :
City : NAYLOR
State : GA
Zip : 31641-2563
Country : US
Telephone Number : 229-247-4633
Fax Number :
Provider Business Practice Location Address
First Line : 5975 LAKE SHORE DR
Second Line :
City : NAYLOR
State : GA
Zip : 31641-2563
Country : US
Telephone Number : 229-247-4633
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/31/2007
Last Update Date : 08/31/2007

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Directions to “ MS. VIRGINIA N GILBRIDE M.ED.” Practice Location

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