MEDICARE: GEORGINA GONZALEZ APRN, 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	AP139449	TX
2	363LF0000X	Family Nurse Practitioner	318907	AZ
3	363LF0000X	Family Nurse Practitioner	C-APN.0103299-C-NP	CO
4	363LF0000X	Family Nurse Practitioner	53-85482-122	KS
5	363LF0000X	Family Nurse Practitioner	2024033802	MO
6	363LF0000X	Family Nurse Practitioner	APRN.CNP.0028021	OH
7	363LF0000X	Family Nurse Practitioner	10054634	OR
8	363LF0000X	Family Nurse Practitioner	86862	NM
9	363LF0000X	Family Nurse Practitioner	209031250	IL
10	363LF0000X	Family Nurse Practitioner	AP61321293	WA

General Provider Information

NPI Number	:	1275090698
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	GEORGINA GONZALEZ APRN, FNP-C

Provider Business Mailing Address
First Line	:	PO BOX 211699
Second Line	:
City	:	EAGAN
State	:	MN
Zip	:	55121-3699
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

Provider Business Practice Location Address
First Line	:	20405 STATE HIGHWAY 249
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77070-2618
Country	:	US
Telephone Number	:	866-849-0692
Fax Number	:	888-973-8821

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

Provider Enumeration Date	:	02/21/2019
Last Update Date	:	04/13/2026

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Directions to “ GEORGINA GONZALEZ APRN, FNP-C” Practice Location

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