Provider Demographics
NPI:1669446076
Name:JENSEN, KRISTINA L (DC)
Entity Type:Individual
Prefix:MS
First Name:KRISTINA
Middle Name:L
Last Name:JENSEN
Suffix:
Gender:F
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3213 TUSCANY WAY
Mailing Address - Street 2:
Mailing Address - City:BOYNTON BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33435-7811
Mailing Address - Country:US
Mailing Address - Phone:561-738-2085
Mailing Address - Fax:561-738-2085
Practice Address - Street 1:3213 TUSCANY WAY
Practice Address - Street 2:
Practice Address - City:BOYNTON BEACH
Practice Address - State:FL
Practice Address - Zip Code:33435-7811
Practice Address - Country:US
Practice Address - Phone:561-738-2085
Practice Address - Fax:561-738-2085
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-02-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLFLCH7191111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
U64875Medicare UPIN
55524Medicare ID - Type Unspecified