Provider Demographics
NPI:1558974428
Name:REGI, GISHA (NURSE PRACTICTIONER)
Entity type:Individual
Prefix:MRS
First Name:GISHA
Middle Name:
Last Name:REGI
Suffix:
Gender:F
Credentials:NURSE PRACTICTIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 E BROAD ST STE 101
Mailing Address - Street 2:
Mailing Address - City:MANSFIELD
Mailing Address - State:TX
Mailing Address - Zip Code:76063-5623
Mailing Address - Country:US
Mailing Address - Phone:817-717-9597
Mailing Address - Fax:833-992-1938
Practice Address - Street 1:3807 E BROAD ST STE 101
Practice Address - Street 2:
Practice Address - City:MANSFIELD
Practice Address - State:TX
Practice Address - Zip Code:76063-5623
Practice Address - Country:US
Practice Address - Phone:817-717-9597
Practice Address - Fax:833-992-1938
Is Sole Proprietor?:Yes
Enumeration Date:2020-08-28
Last Update Date:2025-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP141773363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily