Provider Demographics
NPI:1306014584
Name:JENSEN, MARTHA JEANNE (RN)
Entity Type:Individual
Prefix:MS
First Name:MARTHA
Middle Name:JEANNE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8825 IROQUOIS RD
Mailing Address - Street 2:
Mailing Address - City:SAINT HELEN
Mailing Address - State:MI
Mailing Address - Zip Code:48656-9746
Mailing Address - Country:US
Mailing Address - Phone:090-389-3989
Mailing Address - Fax:
Practice Address - Street 1:1629 N WASHINGTON AVE
Practice Address - Street 2:GMHS SMCO MEDICAL DEPT
Practice Address - City:SAGINAW
Practice Address - State:MI
Practice Address - Zip Code:48601-1211
Practice Address - Country:US
Practice Address - Phone:989-757-0518
Practice Address - Fax:989-757-1597
Is Sole Proprietor?:Yes
Enumeration Date:2008-02-11
Last Update Date:2008-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704101301163WX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WX0106XNursing Service ProvidersRegistered NurseOccupational Health