Provider Demographics
NPI:1558043463
Name:GEMIA, FLORENCE DANGGA
Entity Type:Individual
Prefix:
First Name:FLORENCE
Middle Name:DANGGA
Last Name:GEMIA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:FLORENCE
Other - Middle Name:DANGGA
Other - Last Name:GEMIA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP
Mailing Address - Street 1:9527 FOSSIL CANYON DR
Mailing Address - Street 2:
Mailing Address - City:HUMBLE
Mailing Address - State:TX
Mailing Address - Zip Code:77396-3084
Mailing Address - Country:US
Mailing Address - Phone:832-573-4415
Mailing Address - Fax:
Practice Address - Street 1:9527 FOSSIL CANYON DR
Practice Address - Street 2:
Practice Address - City:HUMBLE
Practice Address - State:TX
Practice Address - Zip Code:77396-3084
Practice Address - Country:US
Practice Address - Phone:832-573-4415
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1112450363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care