Provider Demographics
NPI:1003268772
Name:JENSEN, BREE YAEGER (DNP, APRN, CNP)
Entity Type:Individual
Prefix:MRS
First Name:BREE
Middle Name:YAEGER
Last Name:JENSEN
Suffix:
Gender:F
Credentials:DNP, APRN, CNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1634 HILLCREST AVE
Mailing Address - Street 2:
Mailing Address - City:SAINT PAUL
Mailing Address - State:MN
Mailing Address - Zip Code:55116-2147
Mailing Address - Country:US
Mailing Address - Phone:651-331-9131
Mailing Address - Fax:
Practice Address - Street 1:5520 RIDGEWOOD CV
Practice Address - Street 2:
Practice Address - City:MINNETRISTA
Practice Address - State:MN
Practice Address - Zip Code:55364-8239
Practice Address - Country:US
Practice Address - Phone:612-865-5262
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-07-06
Last Update Date:2016-07-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNCNP 4596363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner