Provider Demographics
NPI:1942709548
Name:GONZALEZ, CHRISTINA MARIE NASCA (PHARMD)
Entity type:Individual
Prefix:DR
First Name:CHRISTINA
Middle Name:MARIE NASCA
Last Name:GONZALEZ
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:DR
Other - First Name:CHRISTINA
Other - Middle Name:MARIE
Other - Last Name:NASCA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHARMD
Mailing Address - Street 1:30 SHELBURNE SHOPPING PARK
Mailing Address - Street 2:
Mailing Address - City:SHELBURNE
Mailing Address - State:VT
Mailing Address - Zip Code:05482-7488
Mailing Address - Country:US
Mailing Address - Phone:802-985-2610
Mailing Address - Fax:802-985-0141
Practice Address - Street 1:30 SHELBURNE SHOPPING PARK
Practice Address - Street 2:
Practice Address - City:SHELBURNE
Practice Address - State:VT
Practice Address - Zip Code:05482-7488
Practice Address - Country:US
Practice Address - Phone:802-985-2610
Practice Address - Fax:802-985-0141
Is Sole Proprietor?:No
Enumeration Date:2018-02-08
Last Update Date:2018-02-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT003.0111959183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT003.0111959OtherPHARMACIST LICENSE