Individual
MS. KEENA JOY ENNIS CHUNG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP, CPNP-AC
Contact information
Practice address
4900 MUELLER BLVD, DELL CHILDREN'S MEDICAL CENTER, AUSTIN, TX 78723-3079
(512) 324-0000
(512) 324-0721
Mailing address
4900 MUELLER BLVD, DELL CHILDREN'S MEDICAL CENTER, AUSTIN, TX 78723
(512) 324-0000
(512) 324-0721
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
AP115959
TX
363LA2100X
Acute Care Nurse Practitioner
Primary
741808
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
741808
LICENSE NUMBER
TX
01
—
7770
PRESCRIPTIVE AUTHORITY
TX
01
—
Y0195445
DPS
TX
Enumeration date
07/08/2006
Last updated
03/07/2023
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