Provider Demographics
NPI:1174027874
Name:JENSEN, ERIK GNANDT
Entity Type:Individual
Prefix:
First Name:ERIK
Middle Name:GNANDT
Last Name:JENSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:825 N GIBSON RD STE 311
Mailing Address - Street 2:
Mailing Address - City:HENDERSON
Mailing Address - State:NV
Mailing Address - Zip Code:89011-1708
Mailing Address - Country:US
Mailing Address - Phone:702-776-8300
Mailing Address - Fax:702-776-8303
Practice Address - Street 1:825 N GIBSON RD STE 311
Practice Address - Street 2:
Practice Address - City:HENDERSON
Practice Address - State:NV
Practice Address - Zip Code:89011-1708
Practice Address - Country:US
Practice Address - Phone:702-776-8300
Practice Address - Fax:702-776-8303
Is Sole Proprietor?:No
Enumeration Date:2018-03-19
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NV20853207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease