MEDICARE: AMESIHA GIBSON 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	1183819	TX
2	363L00000X	Nurse Practitioner	1183819	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	1183819	OTHER	TX	NURSING

General Provider Information

NPI Number	:	1851101273
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	AMESIHA GIBSON FNP-C

Provider Business Mailing Address
First Line	:	227 MESA RDG
Second Line	:
City	:	DECATUR
State	:	TX
Zip	:	76234-5277
Country	:	US
Telephone Number	:	601-316-2086
Fax Number	:

Provider Business Practice Location Address
First Line	:	2900 N INTERSTATE 35 STE 401
Second Line	:
City	:	DENTON
State	:	TX
Zip	:	76201-5148
Country	:	US
Telephone Number	:	940-565-9557
Fax Number	:	972-226-0206

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

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	12/16/2025

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Directions to “ AMESIHA GIBSON FNP-C” Practice Location

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