Provider Demographics
NPI:1609203793
Name:JEANSONNE, JANICE GUILLOT (NURSE PRACTITIONER)
Entity Type:Individual
Prefix:MRS
First Name:JANICE
Middle Name:GUILLOT
Last Name:JEANSONNE
Suffix:
Gender:F
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2906 LAUREL MIST CT
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-4942
Mailing Address - Country:US
Mailing Address - Phone:281-300-6947
Mailing Address - Fax:
Practice Address - Street 1:9305 PINECROFT DR
Practice Address - Street 2:SUITE 300
Practice Address - City:THE WOODLANDS
Practice Address - State:TX
Practice Address - Zip Code:77380-3482
Practice Address - Country:US
Practice Address - Phone:713-897-7221
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-10-03
Last Update Date:2013-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX639519363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily