Provider Demographics
NPI:1518441526
Name:JENSEN, ANGELA E (FNP-BC)
Entity Type:Individual
Prefix:
First Name:ANGELA
Middle Name:E
Last Name:JENSEN
Suffix:
Gender:F
Credentials:FNP-BC
Other - Prefix:
Other - First Name:ANGELA
Other - Middle Name:
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:FNP-BC
Mailing Address - Street 1:1447 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SAGINAW
Mailing Address - State:MI
Mailing Address - Zip Code:48602-4727
Mailing Address - Country:US
Mailing Address - Phone:989-763-4994
Mailing Address - Fax:
Practice Address - Street 1:1910 PINE AVE
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:MI
Practice Address - Zip Code:48801-1298
Practice Address - Country:US
Practice Address - Phone:989-463-3101
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-17
Last Update Date:2019-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4704258351363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner