Keena Joy Ennis Chung in Austin - Nurse Practitioner

Keena Joy Ennis Chung - NPI 1245263805

Keena Joy Ennis Chung is a Nurse Practitioner in Austin, Texas. Keena Joy Ennis Chung practices all healthcare services and medical treatments related to Nurse Practitioner. The NPI Number for Keena Joy Ennis Chung is 1245263805. The last update date is 2023-03-07.

Keena Joy Ennis Chung's current location address is 4900 Mueller Blvd, Austin, Texas. You can contact this provider via phone number 5123240000 and fax number 5123240721. The mailing address for Keena Joy Ennis Chung is 4900 Mueller Blvd, Austin, Texas. To know further, please read the information below!

Provider Profile Detail

Provider Name Keena Joy Ennis Chung
Address 4900 Mueller Blvd, Austin, Texas
Phone Number 5123240000
Fax Number 5123240721
Sole Proprietor N
Credentials CFNP, CPNP

NPI Number Detail

NPI Number 1245263805
Provider Enumeration Date 2006-07-08
Last Updated Date 2023-03-07

Provider Mailing Address Detail

Address 4900 Mueller Blvd
City Austin
State Texas (TX)
Post Code 78723
Phone Number 5123240000
Fax Number 5123240721

Provider's Primary Taxonomy Detail

Speciality Nurse Practitioner
Taxonomy 363L00000X
Licence No AP115959
Definition:
(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certifi

Provider's Other Legacy Identifiers

Identifier Identifier Type Identifier State Identifier Issuer
741808 TX LICENSE NUMBER
7770 TX PRESCRIPTIVE AUTHORITY
Y0195445 TX DPS

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FAQs about Keena Joy Ennis Chung

What is the unique provider identifier assigned to Keena Joy Ennis Chung?

The Keena Joy Ennis Chung has been issued the NPI (National Provider Identifier) 1245263805 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code is a unique identification number for healthcare providers.

Could you please provide the complete physical location address of Keena Joy Ennis Chung?

The Keena Joy Ennis Chung is physically situated at 4900 Mueller Blvd, in the city of Austin, state of TX, with the postal code 78723.

What is Keena Joy Ennis Chung's specialized field of practice, and what is the corresponding taxonomy classification code?

The Keena Joy Ennis Chung's area of specialization is Nurse Practitioner, and the corresponding taxonomy code that categorizes this field of practice is 363L00000X.

On what date did the Keena Joy Ennis Chung receive the assignment of its 1245263805 from the Centers for Medicare & Medicaid Services?

The Keena Joy Ennis Chung was issued its 1245263805 by the Centers for Medicare & Medicaid Services on 2006-07-08.

When was the information pertaining to Keena Joy Ennis Chung most recently updated or revised?

The details related to Keena Joy Ennis Chung, including its address, specialty, and other relevant information, were last updated or revised on 2023-03-07.

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