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Individual

JONATHAN JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
PMB 216 1270 N MARINE CORPS DR STE 101, TAMUNING, GU 96913
(671) 486-6368
Mailing address
PMB 216 1270 N MARINE CORPS DR STE 101, TAMUNING, GU 96913

Taxonomy

Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
188207-30
WI
163W00000X
Registered Nurse
748709
CA
163W00000X
Registered Nurse
R206734-2
MN
367500000X
Certified Registered Nurse Anesthetist
188207-30
WI
367500000X
Certified Registered Nurse Anesthetist
Primary
NP1046
GU
367500000X
Certified Registered Nurse Anesthetist
RE1979
GU

Other

Enumeration date
10/21/2014
Last updated
09/02/2016
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