Provider Demographics
NPI:1518268309
Name:JENSEN, MADALINE R (RN)
Entity Type:Individual
Prefix:
First Name:MADALINE
Middle Name:R
Last Name:JENSEN
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1102 VICTORY AVE
Mailing Address - Street 2:
Mailing Address - City:BILLINGS
Mailing Address - State:MT
Mailing Address - Zip Code:59105-1855
Mailing Address - Country:US
Mailing Address - Phone:406-245-6892
Mailing Address - Fax:
Practice Address - Street 1:1102 VICTORY AVE
Practice Address - Street 2:
Practice Address - City:BILLINGS
Practice Address - State:MT
Practice Address - Zip Code:59105-1855
Practice Address - Country:US
Practice Address - Phone:406-245-6892
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-11-09
Last Update Date:2010-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ZZ8819104163WE0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WE0003XNursing Service ProvidersRegistered NurseEmergency