MEDICARE: MS. KATIE ANN GIBBINS FNP-C

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
1	363LF0000X	Family Nurse Practitioner	1084281	TX

General Provider Information

NPI Number	:	1528596780
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. KATIE ANN GIBBINS FNP-C

Provider Business Mailing Address
First Line	:	4196 HIGHWAY 62 412 STE A
Second Line	:
City	:	HARDY
State	:	AR
Zip	:	72542-8002
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1700 WFM 700
Second Line	:	STE B
City	:	BIG SPRING
State	:	TX
Zip	:	79720-4120
Country	:	US
Telephone Number	:	432-264-1911
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/31/2017
Last Update Date	:	02/06/2026

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