Individual
PATRICIA JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LPN
Contact information
Practice address
845 E FAIRVIEW AVE STE 120, MERIDIAN, ID 83642-8048
(208) 887-6283
(208) 887-7759
Mailing address
845 E FAIRVIEW AVE STE 120, MERIDIAN, ID 83642-8048
(208) 887-6283
(208) 887-7759
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
PN-9105
ID
225700000X
Massage Therapist
Primary
—
—
3747P1801X
Personal Care Attendant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
M8059118
—
ID
Enumeration date
04/19/2011
Last updated
04/19/2011
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