Provider Demographics
NPI:1417359548
Name:JENSEN, JOSI KELLY (CNM)
Entity Type:Individual
Prefix:MRS
First Name:JOSI
Middle Name:KELLY
Last Name:JENSEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1303 N MAIN ST STE E
Mailing Address - Street 2:
Mailing Address - City:CEDAR CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84721-9746
Mailing Address - Country:US
Mailing Address - Phone:435-865-9222
Mailing Address - Fax:435-586-1467
Practice Address - Street 1:1303 N MAIN ST STE E
Practice Address - Street 2:
Practice Address - City:CEDAR CITY
Practice Address - State:UT
Practice Address - Zip Code:84721-9746
Practice Address - Country:US
Practice Address - Phone:435-865-9222
Practice Address - Fax:435-586-1467
Is Sole Proprietor?:No
Enumeration Date:2014-09-19
Last Update Date:2018-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT8031026-4402367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife