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Individual
JILL N JENSEN
Active
Individual
JILL N JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001628
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0260125
—
IA
05
—
1477652469
—
IA
05
—
47068731712
—
IA
Enumeration date
09/22/2006
Last updated
03/17/2018
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