Individual provider Active NPI

Nirvana Abou-Gabal, CNS, LDN

  • Nutritionist
  • Virginia Beach, VA
National Provider Identifier
1093438913
Registry record updated Sep 26, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
NutritionistTaxonomy code 133N00000X
License
DX5300 Issued in MD
Practice address
4445 Corporation LN Ste 264
Virginia Beach, VA 23462-3262
Phone
(202) 460-7030
NPI assigned
Sep 26, 2022
Last updated
Sep 26, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 26, 2022

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutritionist 133N00000X DX5300 MD Primary

Addresses

Primary practice location

4445 Corporation LN Ste 264
Virginia Beach, VA 23462-3262

Mailing address

PO Box 591
Ivy, VA 22945-0591
Phone (202) 460-7030

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Certified Nurse Specialist

State licenses

LicenseStateTypeSpecialty
DX5300MDMDNutritionist

Practice roles

OrganizationSpecialtyStatusNew patients
Nourished Living LLC CurrentSince Nov 18, 2025 Accepting new patients

Locations

4445 Corporation Ln
Ste 264
Virginia Beach, VA 23462
Phone (561) 556-2656

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1664150400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664150400000",
    "number": "1093438913",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 591",
            "city": "IVY",
            "state": "VA",
            "postal_code": "229450591",
            "telephone_number": "202-460-7030"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4445 CORPORATION LN STE 264",
            "city": "VIRGINIA BEACH",
            "state": "VA",
            "postal_code": "234623262",
            "telephone_number": "202-460-7030"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ABOU-GABAL",
        "first_name": "NIRVANA",
        "credential": "CNS, LDN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-09-26",
        "last_updated": "2022-09-26",
        "certification_date": "2022-09-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133N00000X",
            "taxonomy_group": "",
            "desc": "Nutritionist",
            "state": "MD",
            "license": "DX5300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Virginia Beach, VA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 26, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.