Provider Demographics
NPI:1053853549
Name:PICTON, JOANNE JOYCELYN (NP)
Entity Type:Individual
Prefix:
First Name:JOANNE
Middle Name:JOYCELYN
Last Name:PICTON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JANA
Other - Middle Name:
Other - Last Name:PICTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:FNP
Mailing Address - Street 1:11801 SOUTH FWY
Mailing Address - Street 2:STE 338
Mailing Address - City:BURLESON
Mailing Address - State:TX
Mailing Address - Zip Code:76028-7021
Mailing Address - Country:US
Mailing Address - Phone:817-568-3253
Mailing Address - Fax:817-551-2570
Practice Address - Street 1:11801 SOUTH FWY
Practice Address - Street 2:STE 338
Practice Address - City:BURLESON
Practice Address - State:TX
Practice Address - Zip Code:76028-7021
Practice Address - Country:US
Practice Address - Phone:817-568-3253
Practice Address - Fax:817-551-2570
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-15
Last Update Date:2016-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX441145363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily