Provider Demographics
NPI:1023539855
Name:SOILEAU, JANICE (CPNP-PC)
Entity Type:Individual
Prefix:
First Name:JANICE
Middle Name:
Last Name:SOILEAU
Suffix:
Gender:F
Credentials:CPNP-PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1900 SCENIC DR STE 2210
Mailing Address - Street 2:
Mailing Address - City:GEORGETOWN
Mailing Address - State:TX
Mailing Address - Zip Code:78626-7703
Mailing Address - Country:US
Mailing Address - Phone:512-693-4041
Mailing Address - Fax:
Practice Address - Street 1:1900 SCENIC DR STE 2210
Practice Address - Street 2:
Practice Address - City:GEORGETOWN
Practice Address - State:TX
Practice Address - Zip Code:78626-7703
Practice Address - Country:US
Practice Address - Phone:512-693-4041
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-01
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX754063163W00000X
TXAP129907363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
No163W00000XNursing Service ProvidersRegistered Nurse