Individual
NICOLE JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
375 FOUR LEAF LN STE 103, CHARLOTTESVILLE, VA 22903-6905
(434) 243-0700
(434) 243-0680
Mailing address
PO BOX 9007, CHARLOTTESVILLE, VA 22906-9007
(434) 295-1000
(434) 972-4266
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
0101269111
VA
Other
Enumeration date
05/16/2017
Last updated
10/13/2020
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