Healthcare Provider Details

I. General information

NPI: 1851101273
Provider Name (Legal Business Name): AMESIHA GIBSON FNP-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 01/08/2025
Last Update Date: 12/16/2025
Certification Date: 12/16/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2900 N INTERSTATE 35 STE 401
DENTON TX
76201-5148
US

IV. Provider business mailing address

227 MESA RDG
DECATUR TX
76234-5277
US

V. Phone/Fax

Practice location:
  • Phone: 940-565-9557
  • Fax: 972-226-0206
Mailing address:
  • Phone: 601-316-2086
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1183819
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1183819
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: