Healthcare Provider Details

I. General information

NPI: 1235209008
Provider Name (Legal Business Name): JANICE LYNN PATLUK FNP, GNP, RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/09/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CACTUS HEALTH SERVICES, INC. 213 PERSIMMON
SANDERSON TX
79848-0244
US

IV. Provider business mailing address

PO BOX 163
SANDERSON TX
79848-0163
US

V. Phone/Fax

Practice location:
  • Phone: 432-345-2508
  • Fax: 432-345-2426
Mailing address:
  • Phone: 817-648-8641
  • Fax: 432-345-2426

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number500576
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number500576
License Number StateTX
# 3
Primary TaxonomyN
Taxonomy Code363LG0600X
TaxonomyGerontology Nurse Practitioner
License Number500576
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: