Provider Demographics
NPI:1932688280
Name:ENOX, GERALD JUSTIN (RN, BSN, FNP-C)
Entity Type:Individual
Prefix:
First Name:GERALD
Middle Name:JUSTIN
Last Name:ENOX
Suffix:
Gender:M
Credentials:RN, BSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:950 JANA ST
Mailing Address - Street 2:
Mailing Address - City:RENO
Mailing Address - State:TX
Mailing Address - Zip Code:75462-6110
Mailing Address - Country:US
Mailing Address - Phone:903-421-3809
Mailing Address - Fax:
Practice Address - Street 1:1301 E MAIN ST
Practice Address - Street 2:
Practice Address - City:HONEY GROVE
Practice Address - State:TX
Practice Address - Zip Code:75446-1268
Practice Address - Country:US
Practice Address - Phone:903-378-3444
Practice Address - Fax:903-378-3445
Is Sole Proprietor?:No
Enumeration Date:2018-08-08
Last Update Date:2023-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1006721363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily