Provider Demographics
NPI:1518789577
Name:SUBEDI, GITA DEVI (FNP)
Entity type:Individual
Prefix:MRS
First Name:GITA
Middle Name:DEVI
Last Name:SUBEDI
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 1:1009 CUSHING DR
Mailing Address - Street 2:
Mailing Address - City:FORT WORTH
Mailing Address - State:TX
Mailing Address - Zip Code:76177-1694
Mailing Address - Country:US
Mailing Address - Phone:720-768-3101
Mailing Address - Fax:
Practice Address - Street 1:800 MEDICAL CENTER DR STE C
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:TX
Practice Address - Zip Code:76234-3844
Practice Address - Country:US
Practice Address - Phone:940-626-2110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-30
Last Update Date:2024-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1035039363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily