Provider Demographics
NPI:1700516671
Name:VINEY, JENNY LYN (APRN)
Entity Type:Individual
Prefix:
First Name:JENNY
Middle Name:LYN
Last Name:VINEY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1810 LOFTY MAPLE TRL
Mailing Address - Street 2:
Mailing Address - City:KINGWOOD
Mailing Address - State:TX
Mailing Address - Zip Code:77345-1938
Mailing Address - Country:US
Mailing Address - Phone:719-201-0686
Mailing Address - Fax:
Practice Address - Street 1:121 VISION PARK BLVD STE 200
Practice Address - Street 2:
Practice Address - City:SHENANDOAH
Practice Address - State:TX
Practice Address - Zip Code:77384-3027
Practice Address - Country:US
Practice Address - Phone:281-725-6767
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-14
Last Update Date:2022-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX1038819363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics