Provider Demographics
NPI:1346574407
Name:JENSEN, SHEILA ANN (NP)
Entity Type:Individual
Prefix:
First Name:SHEILA
Middle Name:ANN
Last Name:JENSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:315 MULBERRY ST
Mailing Address - Street 2:
Mailing Address - City:EVANSVILLE
Mailing Address - State:IN
Mailing Address - Zip Code:47713-1252
Mailing Address - Country:US
Mailing Address - Phone:812-421-7489
Mailing Address - Fax:812-421-7497
Practice Address - Street 1:25 W DIVISION ST
Practice Address - Street 2:
Practice Address - City:EVANSVILLE
Practice Address - State:IN
Practice Address - Zip Code:47710-1374
Practice Address - Country:US
Practice Address - Phone:812-436-0205
Practice Address - Fax:812-436-0207
Is Sole Proprietor?:No
Enumeration Date:2009-09-22
Last Update Date:2021-01-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN28121126A363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200964740Medicaid
M400038576Medicare Oscar/Certification