Individual
AMANDA RAE JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP-BC
Contact information
Practice address
7904 CABELA DR, HAMMOND, IN 46324-2950
(219) 554-9911
(219) 554-9912
Mailing address
11419 GEORGIA ST, CROWN POINT, IN 46307-0035
(219) 487-9062
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
28186494A
IN
Other
Enumeration date
03/29/2021
Last updated
07/12/2021
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