Provider Demographics
NPI:1407187552
Name:JENSEN, SHERRI (ARNP)
Entity Type:Individual
Prefix:
First Name:SHERRI
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4002 RAULERSON DR
Mailing Address - Street 2:
Mailing Address - City:GREENACRES
Mailing Address - State:FL
Mailing Address - Zip Code:33463-8927
Mailing Address - Country:US
Mailing Address - Phone:561-964-4077
Mailing Address - Fax:561-964-9296
Practice Address - Street 1:4002 RAULERSON DR
Practice Address - Street 2:
Practice Address - City:GREENACRES
Practice Address - State:FL
Practice Address - Zip Code:33463-8927
Practice Address - Country:US
Practice Address - Phone:561-964-4077
Practice Address - Fax:561-964-9296
Is Sole Proprietor?:No
Enumeration Date:2010-01-28
Last Update Date:2010-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL1905132207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine