MEDICARE: JERA GIBELLI FNP

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	F12240450	TX
2	363LF0000X	Family Nurse Practitioner	82725	NM

General Provider Information

NPI Number	:	1881404333
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JERA GIBELLI FNP

Provider Business Mailing Address
First Line	:	6513 HARAPON ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-2559
Country	:	US
Telephone Number	:	915-487-4391
Fax Number	:

Provider Business Practice Location Address
First Line	:	6513 HARAPON ST
Second Line	:
City	:	EL PASO
State	:	TX
Zip	:	79932-2559
Country	:	US
Telephone Number	:	915-487-4391
Fax Number	:

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

Provider Enumeration Date	:	01/08/2025
Last Update Date	:	03/23/2026

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