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Individual

JILL N JENSEN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
1001 RISEN SON BLVD, COUNCIL BLUFFS, IA 51503-1910
(712) 256-8600
(712) 256-8599
Mailing address
PO BOX 3755, OMAHA, NE 68103-0755
(402) 354-2100
(402) 354-2155

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001628
IA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0260125
IA
05
1477652469
IA
05
47068731712
IA
Enumeration date
09/22/2006
Last updated
03/17/2018
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