Provider Demographics
NPI:1104936079
Name:JUNEAU, CHERYL (CFNP)
Entity type:Individual
Prefix:MISS
First Name:CHERYL
Middle Name:
Last Name:JUNEAU
Suffix:
Gender:F
Credentials:CFNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6560 FANNIN ST STE 1130
Mailing Address - Street 2:
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-2790
Mailing Address - Country:US
Mailing Address - Phone:713-797-1087
Mailing Address - Fax:713-797-9814
Practice Address - Street 1:6560 FANNIN ST STE 1130
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-2790
Practice Address - Country:US
Practice Address - Phone:713-797-1087
Practice Address - Fax:713-797-9814
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX11111363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner