Provider Demographics
NPI:1922231653
Name:JENSEN-LAUDENBACH, DONNA LYNN (LPN)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:LYNN
Last Name:JENSEN-LAUDENBACH
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:DONNA
Other - Middle Name:
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:308 9TH ST N
Mailing Address - Street 2:
Mailing Address - City:KERKHOVEN
Mailing Address - State:MN
Mailing Address - Zip Code:56252-9346
Mailing Address - Country:US
Mailing Address - Phone:320-360-1776
Mailing Address - Fax:
Practice Address - Street 1:246 MAIN STREET SOUTH
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:MN
Practice Address - Zip Code:55350
Practice Address - Country:US
Practice Address - Phone:320-587-5462
Practice Address - Fax:320-234-7950
Is Sole Proprietor?:No
Enumeration Date:2009-08-28
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNL68307-4164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse