Provider Demographics
NPI:1689150369
Name:JENSEN, KRISTI (PHARMD)
Entity Type:Individual
Prefix:DR
First Name:KRISTI
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 RANCH VIEW LN
Mailing Address - Street 2:
Mailing Address - City:ELKHORN
Mailing Address - State:NE
Mailing Address - Zip Code:68022-2590
Mailing Address - Country:US
Mailing Address - Phone:402-651-6645
Mailing Address - Fax:
Practice Address - Street 1:1531 N BELL ST
Practice Address - Street 2:
Practice Address - City:FREMONT
Practice Address - State:NE
Practice Address - Zip Code:68025-3536
Practice Address - Country:US
Practice Address - Phone:402-727-1995
Practice Address - Fax:402-753-0073
Is Sole Proprietor?:No
Enumeration Date:2018-07-16
Last Update Date:2018-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11049183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist