Provider Demographics
NPI:1104204700
Name:KURIEN, JENSY
Entity Type:Individual
Prefix:
First Name:JENSY
Middle Name:
Last Name:KURIEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 WASHINGTON ST
Mailing Address - Street 2:SUITE 305
Mailing Address - City:HOLLYWOOD
Mailing Address - State:FL
Mailing Address - Zip Code:33021-8256
Mailing Address - Country:US
Mailing Address - Phone:954-981-7070
Mailing Address - Fax:954-983-8510
Practice Address - Street 1:3700 WASHINGTON ST
Practice Address - Street 2:SUITE 305
Practice Address - City:HOLLYWOOD
Practice Address - State:FL
Practice Address - Zip Code:33021-8256
Practice Address - Country:US
Practice Address - Phone:954-981-7070
Practice Address - Fax:954-983-8510
Is Sole Proprietor?:No
Enumeration Date:2015-05-14
Last Update Date:2015-09-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9399014363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner