| Doctor Name: | KELLY M JENSEN |
| NPI Number: | 1326131335 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | PA-C |
| License Number: | 5601003267 |
| Business Practice Address: | 6401 Prairie St Suite 2300 Norton Shores, MI - 494447840 |
| Business Phone Number: | 2317277928 |
| Business Fax Number: | 2317247844 |
| Mailing Address: | Po Box 1847, MUSKEGON |
| State: | MI |
| Postal Code: | 494431847 |
| Phone Number: | 2317274444 |
| Fax Number: | 2317284789 |
| NPI Enumeration Date: | 10/02/2006 |
| NPI Last Update Date: | 02/20/2013 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 5601003267 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | MI |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |