Provider Demographics
NPI:1700477437
Name:JENSEN, HOLLY LEANNE (APRN, FNP-C)
Entity Type:Individual
Prefix:
First Name:HOLLY
Middle Name:LEANNE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:APRN, FNP-C
Other - Prefix:
Other - First Name:HOLLY
Other - Middle Name:LEANNE
Other - Last Name:INMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5963 SEQUOIA CIR
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32967-6074
Mailing Address - Country:US
Mailing Address - Phone:772-532-4818
Mailing Address - Fax:
Practice Address - Street 1:1000 37TH PL STE 105
Practice Address - Street 2:
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960-6579
Practice Address - Country:US
Practice Address - Phone:772-562-2402
Practice Address - Fax:772-562-5842
Is Sole Proprietor?:No
Enumeration Date:2021-01-26
Last Update Date:2021-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL11011277363LF0000X
FL9299707163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163W00000XNursing Service ProvidersRegistered Nurse