Individual
MS. LISA K JENSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
FNP CNM
Contact information
Practice address
331 UPPER PLAIN, BRADFORD, VT 05033
(802) 222-4722
(802) 222-4709
Mailing address
88 ASH HILL ROAD, LYMAN, NH 03585
(603) 838-6130
Taxonomy
Speciality
Code
Description
License number
State
176B00000X
Midwife
0256212301
NH
363LF0000X
Family Nurse Practitioner
Primary
1010025554
VT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1003832
—
VT
05
—
30005029
—
NH
Enumeration date
10/16/2006
Last updated
12/23/2011
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