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NPI Code Detail

MEDICARE: MRS. GISHA REGI NURSE PRACTICTIONER

MEDICARE: MRS. GISHA REGI NURSE PRACTICTIONER
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
1363LF0000XFamily Nurse PractitionerAP141773TX

General Provider Information

NPI Number : 1558974428
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. GISHA REGI NURSE PRACTICTIONER
Provider Business Mailing Address
First Line : 3807 E BROAD ST STE 101
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-5623
Country : US
Telephone Number : 817-717-9597
Fax Number : 833-992-1938
Provider Business Practice Location Address
First Line : 3807 E BROAD ST STE 101
Second Line :
City : MANSFIELD
State : TX
Zip : 76063-5623
Country : US
Telephone Number : 817-717-9597
Fax Number : 833-992-1938
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/28/2020
Last Update Date : 07/02/2026

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Directions to “ MRS. GISHA REGI NURSE PRACTICTIONER” Practice Location

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