Provider Demographics
NPI:1093827230
Name:JENSEN, ANNE MARIE (PHD)
Entity Type:Individual
Prefix:
First Name:ANNE
Middle Name:MARIE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:ANNE
Other - Middle Name:MARIE
Other - Last Name:JOHNSTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PHD
Mailing Address - Street 1:3068 WINTERGREEN DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52240-4764
Mailing Address - Country:US
Mailing Address - Phone:319-321-7005
Mailing Address - Fax:
Practice Address - Street 1:3068 WINTERGREEN DR
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4764
Practice Address - Country:US
Practice Address - Phone:319-321-7005
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2023-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA600103T00000X
IA00600103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IA73012OtherBCBS OF IOWA