Healthcare Provider Details

I. General information

NPI: 1518749209
Provider Name (Legal Business Name): ALYANNA MEJIA FNP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: ALY MEJIA FNP

II. Dates (important events)

Enumeration Date: 10/17/2023
Last Update Date: 05/27/2025
Certification Date: 05/27/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

427 N GRAND AVE
GAINESVILLE TX
76240-4357
US

IV. Provider business mailing address

427 N GRAND AVE
GAINESVILLE TX
76240-4357
US

V. Phone/Fax

Practice location:
  • Phone: 940-584-1014
  • Fax: 940-584-1013
Mailing address:
  • Phone: 224-578-0590
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number1139817
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: