Individual
DEREK JENSEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
5305 REBECCA RD, LAS VEGAS, NV 89130-1735
(702) 287-8474
Mailing address
5305 REBECCA RD, LAS VEGAS, NV 89130-1735
(702) 287-8474
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
0
FL
2255A2300X
Athletic Trainer
Primary
0506408
NV
390200000X
Student in an Organized Health Care Education/Training Program
0
FL
Other
Enumeration date
08/29/2014
Last updated
12/01/2021
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