Individual provider Active NPI

Jillian Vidrine Soileau, APRN, CPNP

  • Pediatric Nurse Practitioner
  • Eunice, LA
National Provider Identifier
1336453794
Registry record updated Dec 12, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
AP06203 Issued in LA
Practice address
3501 Highway 190 Ste T
Eunice, LA 70535-5129
Phone
(337) 457-8980
Fax
(337) 457-8983
NPI assigned
Jul 27, 2010
Last updated
Dec 12, 2019By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2019

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X AP06203 LA Primary

Addresses

Primary practice location

3501 Highway 190 Ste T
Eunice, LA 70535-5129

Mailing address

2611 Edgewood Rd
Ville Platte, LA 70586-6542
Phone (337) 407-2795

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Pediatric Nurse Practitioner, Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
AP06203LAMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Opelousas General Health System Physician Practices Past Accepting new patients
Great Beginnings Pediatric & Adolescent Medicine, Apmc Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1280188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1336453794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2611 EDGEWOOD RD",
            "city": "VILLE PLATTE",
            "state": "LA",
            "postal_code": "705866542",
            "telephone_number": "337-407-2795",
            "fax_number": "337-407-2798"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3501 HIGHWAY 190 STE T",
            "city": "EUNICE",
            "state": "LA",
            "postal_code": "705355129",
            "telephone_number": "337-457-8980",
            "fax_number": "337-457-8983"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SOILEAU",
        "first_name": "JILLIAN",
        "middle_name": "VIDRINE",
        "name_prefix": "Mrs.",
        "credential": "APRN, CPNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-27",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "LA",
            "license": "AP06203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eunice, LA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.