MEDICARE: MS. JANICE JEAN ILLS RN,CROR,CRNFA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	282N00000X	General Acute Care Hospital	415738	TX

General Provider Information

NPI Number	:	1225111677
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. JANICE JEAN ILLS RN,CROR,CRNFA

Provider Business Mailing Address
First Line	:	8004 TAHOE PARKE CIR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78726-4051
Country	:	US
Telephone Number	:	512-336-8668
Fax Number	:	512-336-8668

Provider Business Practice Location Address
First Line	:	8004 TAHOE PARKE CIR
Second Line	:
City	:	AUSTIN
State	:	TX
Zip	:	78726-4051
Country	:	US
Telephone Number	:	512-336-8668
Fax Number	:	512-336-8668

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/21/2006
Last Update Date	:	01/18/2026

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