Provider Demographics
NPI:1700021391
Name:JENSEN, VERONICA M (NP)
Entity Type:Individual
Prefix:
First Name:VERONICA
Middle Name:M
Last Name:JENSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:671 HOES LN W
Mailing Address - Street 2:EISS
Mailing Address - City:PISCATAWAY
Mailing Address - State:NJ
Mailing Address - Zip Code:08854-8021
Mailing Address - Country:US
Mailing Address - Phone:732-235-4326
Mailing Address - Fax:
Practice Address - Street 1:671 HOES LANE
Practice Address - Street 2:EISS
Practice Address - City:PISCATAWAY
Practice Address - State:NJ
Practice Address - Zip Code:08855
Practice Address - Country:US
Practice Address - Phone:732-235-4326
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2008-12-10
Last Update Date:2013-05-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ26NJ00167400363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health