Individual
DR. KEVIN NEAL JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
3750 E COUNTRY FIELD CIR STE B, WASILLA, AK 99654-6659
(907) 373-1410
Mailing address
3750 E COUNTRY FIELD CIR STE B, WASILLA, AK 99654-6659
(907) 373-1410
(907) 373-1411
Taxonomy
Speciality
Code
Description
License number
State
207YX0905X
Otolaryngology/Facial Plastic Surgery Physician
Primary
107880
AK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1386739837
NPI
AK
05
—
1695669
—
AK
Enumeration date
10/03/2006
Last updated
03/30/2023
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