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MRS. JOYCE EBOBOSERE GENTRY FNP-C PMHNP-BC NPI 1760971105


NPI Information

NPI: 1760971105
Provider Name: MRS. JOYCE EBOBOSERE GENTRY, FNP-C, PMHNP-BC
Classification: Nurse Practitioner - 363LP0808X
Entity Type: Individual

Specialization: Psychiatric/Mental Health

PECOS Registration: Yes

Address:
446 FOREST SQ
LONGVIEW, TX
ZIP 75605
Phone: (903) 331-0162
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MRS. Joyce Ebobosere Gentry, FNP-C, PMHNP-BC is a psychiatric/mental health nurse practitioner in Longview, TX with 4 years of experience. MRS. Joyce Ebobosere Gentry, FNP-C, PMHNP-BC NPI is 1760971105. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

446 FOREST SQ
LONGVIEW, TX
ZIP 75605-401
Phone: (903) 331-0162
Fax: (903) 331-0162

The NPI 1760971105 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 5/1/2018 and was last updated on 4/14/2022.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1363LP0808XNurse PractitionerPsychiatric/Mental HealthAP137345TEXASYes
2363LF0000XNurse PractitionerFamilyAP137345TEXASNo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1391720501MEDICAIDTEXAS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024
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All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.

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