Provider Demographics
NPI:1467263111
Name:JENSEN-NELSON, TANNA BEVERLY (RN)
Entity type:Individual
Prefix:
First Name:TANNA
Middle Name:BEVERLY
Last Name:JENSEN-NELSON
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:220 N 89TH ST STE 202
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4072
Mailing Address - Country:US
Mailing Address - Phone:402-502-5750
Mailing Address - Fax:402-502-1261
Practice Address - Street 1:220 N 89TH ST STE 202
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68114-4072
Practice Address - Country:US
Practice Address - Phone:402-502-5750
Practice Address - Fax:402-502-1261
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-14
Last Update Date:2025-01-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE92175163WA2000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WA2000XNursing Service ProvidersRegistered NurseAdministrator