Provider Demographics
NPI:1093777831
Name:HUSEBY, GAYETTE LYN (NNP)
Entity Type:Individual
Prefix:
First Name:GAYETTE
Middle Name:LYN
Last Name:HUSEBY
Suffix:
Gender:F
Credentials:NNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4025 LITTLE LN
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79922-1913
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1900 N OREGON ST
Practice Address - Street 2:SUITE 312
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79902-3351
Practice Address - Country:US
Practice Address - Phone:915-542-0739
Practice Address - Fax:915-542-0744
Is Sole Proprietor?:No
Enumeration Date:2006-04-05
Last Update Date:2019-11-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX560878163WN0002X
TXAP113437363LN0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LN0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerNeonatal
No163WN0002XNursing Service ProvidersRegistered NurseNeonatal Intensive Care