Provider Demographics
NPI:1689286239
Name:JENSEN, AMANDA (RN- BSN)
Entity Type:Individual
Prefix:MRS
First Name:AMANDA
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:RN- BSN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 29 1/2 RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81504-5383
Mailing Address - Country:US
Mailing Address - Phone:970-260-2356
Mailing Address - Fax:
Practice Address - Street 1:510 29 1/2 RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81504-5383
Practice Address - Country:US
Practice Address - Phone:970-260-2356
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-08-17
Last Update Date:2020-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO184908163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse