Individual
KELLY ANN JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
ARNP
Contact information
Practice address
3920 OUTLOOK RD, SUNNYSIDE, WA 98944-9202
(509) 837-1676
Mailing address
3920 OUTLOOK ROAD, SUNNYSIDE, WA 98944
(509) 837-1676
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
AP60327115
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AP60327115
WASHINGTON STATE ARNP LICENSE
—
Enumeration date
12/26/2012
Last updated
12/26/2012
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