Provider Demographics
NPI:1558752329
Name:VONG, JENNY (MSN, FNP-C)
Entity Type:Individual
Prefix:MRS
First Name:JENNY
Middle Name:
Last Name:VONG
Suffix:
Gender:F
Credentials:MSN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:27700 NORTHWEST FWY STE 100
Mailing Address - Street 2:
Mailing Address - City:CYPRESS
Mailing Address - State:TX
Mailing Address - Zip Code:77433-6767
Mailing Address - Country:US
Mailing Address - Phone:346-231-6850
Mailing Address - Fax:346-231-6851
Practice Address - Street 1:27700 NORTHWEST FWY STE 100
Practice Address - Street 2:
Practice Address - City:CYPRESS
Practice Address - State:TX
Practice Address - Zip Code:77433-6767
Practice Address - Country:US
Practice Address - Phone:346-231-6850
Practice Address - Fax:346-231-6851
Is Sole Proprietor?:No
Enumeration Date:2015-02-13
Last Update Date:2022-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA95001424363LF0000X
TX1048153363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA95001424OtherBOARD OF REGISTERED NURSING