Provider Demographics
NPI:1457522450
Name:JENSEN, SHARON LEE
Entity Type:Individual
Prefix:MRS
First Name:SHARON
Middle Name:LEE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2746 PIONEER AVE
Mailing Address - Street 2:
Mailing Address - City:RICE LAKE
Mailing Address - State:WI
Mailing Address - Zip Code:54868-2436
Mailing Address - Country:US
Mailing Address - Phone:715-234-1636
Mailing Address - Fax:715-736-0780
Practice Address - Street 1:2746 PIONEER AVE
Practice Address - Street 2:
Practice Address - City:RICE LAKE
Practice Address - State:WI
Practice Address - Zip Code:54868-2436
Practice Address - Country:US
Practice Address - Phone:715-234-1636
Practice Address - Fax:715-736-0780
Is Sole Proprietor?:Yes
Enumeration Date:2008-03-18
Last Update Date:2008-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist