Provider Demographics
NPI:1780037861
Name:LIGON-GASTON, JENNIFER LYNN (FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:LYNN
Last Name:LIGON-GASTON
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Gender:F
Credentials:FNP-C
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Mailing Address - Street 1:19782 HIGHWAY 105 W
Mailing Address - Street 2:SUITE 111
Mailing Address - City:MONTGOMERY
Mailing Address - State:TX
Mailing Address - Zip Code:77356-3103
Mailing Address - Country:US
Mailing Address - Phone:936-582-0220
Mailing Address - Fax:936-582-0222
Practice Address - Street 1:19782 HIGHWAY 105 W
Practice Address - Street 2:SUITE 111
Practice Address - City:MONTGOMERY
Practice Address - State:TX
Practice Address - Zip Code:77356-3103
Practice Address - Country:US
Practice Address - Phone:936-582-0220
Practice Address - Fax:936-582-0222
Is Sole Proprietor?:No
Enumeration Date:2016-07-13
Last Update Date:2016-07-13
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TXAP131237363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily