Provider Demographics
NPI:1396045928
Name:WILLIS, JANICE LORRAINE (RN, FNP-BC)
Entity Type:Individual
Prefix:MS
First Name:JANICE
Middle Name:LORRAINE
Last Name:WILLIS
Suffix:
Gender:F
Credentials:RN, FNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2601 CARTWRIGHT RD PMB 134
Mailing Address - Street 2:
Mailing Address - City:MISSOURI CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77459
Mailing Address - Country:US
Mailing Address - Phone:832-978-5209
Mailing Address - Fax:
Practice Address - Street 1:8324 GULF FREEWAY
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77017-4502
Practice Address - Country:US
Practice Address - Phone:281-974-4820
Practice Address - Fax:281-974-4241
Is Sole Proprietor?:Yes
Enumeration Date:2010-10-29
Last Update Date:2010-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX520246363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily