Doctor Name: | MRS. KIMBERLY JOANN JENSEN |
NPI Number: | 1043550429 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | ARNP-C |
License Number: | RN1801412 |
Business Practice Address: | 400 Avenue K Se Suite 6 Winter Haven, FL - 338804123 |
Business Phone Number: | 8632991107 |
Business Fax Number: | 8632913318 |
Mailing Address: | 400 Avenue K Se, Suite 6 WINTER HAVEN |
State: | FL |
Postal Code: | 338804123 |
Phone Number: | 8632991107 |
Fax Number: | 8632913318 |
NPI Enumeration Date: | 02/22/2013 |
NPI Last Update Date: | 02/22/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363LA2200X |
License Number: | RN1801412 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Nurse Practitioner |
Taxonomy Specialization: | Adult Health |
Taxonomy Definition: |