Provider Demographics
NPI:1225297542
Name:JENSEN, TAUSHA MARIE (APRN)
Entity Type:Individual
Prefix:
First Name:TAUSHA
Middle Name:MARIE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11126 FOXMOOR DR
Mailing Address - Street 2:
Mailing Address - City:SANDY
Mailing Address - State:UT
Mailing Address - Zip Code:84092-5250
Mailing Address - Country:US
Mailing Address - Phone:801-269-9939
Mailing Address - Fax:801-269-9949
Practice Address - Street 1:11762S STATE ST 260
Practice Address - Street 2:
Practice Address - City:DRAPER
Practice Address - State:UT
Practice Address - Zip Code:84020-7156
Practice Address - Country:US
Practice Address - Phone:801-316-1313
Practice Address - Fax:801-316-1314
Is Sole Proprietor?:No
Enumeration Date:2008-06-02
Last Update Date:2015-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT5906917-4408363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner