Provider Demographics
NPI:1255834552
Name:CHUNG, JAMIE VICTORIA (MSN, APRN, AGACNP-BC)
Entity Type:Individual
Prefix:
First Name:JAMIE
Middle Name:VICTORIA
Last Name:CHUNG
Suffix:
Gender:F
Credentials:MSN, APRN, AGACNP-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6620 MAIN ST STE 1450
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2346
Mailing Address - Country:US
Mailing Address - Phone:713-798-7367
Mailing Address - Fax:
Practice Address - Street 1:6620 MAIN ST STE 1450
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2346
Practice Address - Country:US
Practice Address - Phone:832-355-1400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-13
Last Update Date:2023-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP136742363LA2100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2100XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAcute Care