Healthcare Provider Details

I. General information

NPI: 1659624328
Provider Name (Legal Business Name): JOAN TURNER BILLEAUD CPNP-PC
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/18/2012
Last Update Date: 06/21/2021
Certification Date: 06/21/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

300 N ALAMO BLVD
MARSHALL TX
75670-3451
US

IV. Provider business mailing address

300 N ALAMO BLVD
MARSHALL TX
75670-3451
US

V. Phone/Fax

Practice location:
  • Phone: 903-472-4800
  • Fax: 903-927-2880
Mailing address:
  • Phone: 903-472-4800
  • Fax: 903-927-2880

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP0200X
TaxonomyPediatric Nurse Practitioner
License Number702320
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: