Provider Demographics
NPI:1376529933
Name:GISLER, JEAN G (FNP)
Entity Type:Individual
Prefix:
First Name:JEAN
Middle Name:G
Last Name:GISLER
Suffix:
Gender:F
Credentials:FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 3276
Mailing Address - Street 2:
Mailing Address - City:VICTORIA
Mailing Address - State:TX
Mailing Address - Zip Code:77903
Mailing Address - Country:US
Mailing Address - Phone:361-575-4100
Mailing Address - Fax:361-575-4111
Practice Address - Street 1:606 E NUECES ST
Practice Address - Street 2:
Practice Address - City:VICTORIA
Practice Address - State:TX
Practice Address - Zip Code:77901
Practice Address - Country:US
Practice Address - Phone:361-575-4100
Practice Address - Fax:361-575-4111
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-15
Last Update Date:2014-05-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX427272363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX8N4330OtherBCBS OF TX #
TX038049502Medicaid
TX038049503Medicaid
TX8Y8655OtherBCBS TX
TX8Y8655OtherBCBS TX
TX8K7296Medicare PIN
TX038049502Medicaid