Provider Demographics
NPI:1497029425
Name:ANDERSON, JANELLE LOUISE (NP)
Entity Type:Individual
Prefix:
First Name:JANELLE
Middle Name:LOUISE
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JANELLE
Other - Middle Name:LOUISE
Other - Last Name:GAILLIARD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3301 UNICORN LAKE BLVD
Mailing Address - Street 2:
Mailing Address - City:DENTON
Mailing Address - State:TX
Mailing Address - Zip Code:76210-0102
Mailing Address - Country:US
Mailing Address - Phone:940-383-1578
Mailing Address - Fax:
Practice Address - Street 1:3301 UNICORN LAKE BLVD
Practice Address - Street 2:
Practice Address - City:DENTON
Practice Address - State:TX
Practice Address - Zip Code:76210-0102
Practice Address - Country:US
Practice Address - Phone:940-383-1578
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-08
Last Update Date:2022-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP132804363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care