Provider Demographics
NPI:1659375046
Name:ROBILLARD, JANET A (PA)
Entity Type:Individual
Prefix:
First Name:JANET
Middle Name:A
Last Name:ROBILLARD
Suffix:
Gender:F
Credentials:PA
Other - Prefix:
Other - First Name:JANET
Other - Middle Name:
Other - Last Name:RODDICK
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA
Mailing Address - Street 1:7974 UW HEALTH CT
Mailing Address - Street 2:
Mailing Address - City:MIDDLETON
Mailing Address - State:WI
Mailing Address - Zip Code:53562-5531
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:600 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:MADISON
Practice Address - State:WI
Practice Address - Zip Code:53792-0001
Practice Address - Country:US
Practice Address - Phone:608-265-1700
Practice Address - Fax:608-263-2201
Is Sole Proprietor?:No
Enumeration Date:2005-06-13
Last Update Date:2021-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI1560363AM0700X, 363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI41970000Medicaid
WI0111Medicare PIN
P79535Medicare UPIN