Individual
MARY J JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Mailing address
200 1ST ST SW, ROCHESTER, MN 55905-0001
(507) 284-2511
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
R0763693
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
36079100
—
WI
05
—
526819200
—
MN
05
—
ENROLLED
—
IA
05
—
ENROLLED
—
WI
01
—
P00849676
RAILROAD MEDICARE
MN
Enumeration date
06/01/2006
Last updated
10/25/2010
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