Provider Demographics
NPI:1164960779
Name:MEHALICK, JANET (FNP-C)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:
Last Name:MEHALICK
Suffix:
Gender:F
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1608 AVENUE J
Mailing Address - Street 2:BOX 2358
Mailing Address - City:HUNTSVILLE
Mailing Address - State:TX
Mailing Address - Zip Code:77341-2358
Mailing Address - Country:US
Mailing Address - Phone:936-294-1805
Mailing Address - Fax:
Practice Address - Street 1:1608 AVENUE J
Practice Address - Street 2:BOX 2358
Practice Address - City:HUNTSVILLE
Practice Address - State:TX
Practice Address - Zip Code:77341-2358
Practice Address - Country:US
Practice Address - Phone:936-294-1805
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-02-02
Last Update Date:2017-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP133140363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily