Provider Demographics
NPI:1417334954
Name:CHEONG, JILLIANNE (NP-C)
Entity type:Individual
Prefix:MRS
First Name:JILLIANNE
Middle Name:
Last Name:CHEONG
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 746079
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-6079
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:832-376-7210
Practice Address - Street 1:11251 FONDREN RD
Practice Address - Street 2:
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77096-5507
Practice Address - Country:US
Practice Address - Phone:281-707-7362
Practice Address - Fax:832-376-7210
Is Sole Proprietor?:No
Enumeration Date:2015-05-05
Last Update Date:2024-11-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXAP127993363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily