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Individual
MS. DIANA ALTHEA JENSEN
Active
Individual
MS. DIANA ALTHEA JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
0101046988
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
038612
BCBS
VA
01
—
2114197
MAMSI
VA
05
—
5604249
—
VA
Enumeration date
12/01/2005
Last updated
11/24/2009
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