Provider Demographics
NPI:1841552536
Name:JENSEN, SARAH LUDLOW (CNM)
Entity type:Individual
Prefix:
First Name:SARAH
Middle Name:LUDLOW
Last Name:JENSEN
Suffix:
Gender:F
Credentials:CNM
Other - Prefix:
Other - First Name:SARAH
Other - Middle Name:B
Other - Last Name:LUDLOW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CNM
Mailing Address - Street 1:601 ELMWOOD AVE
Mailing Address - Street 2:BOX 668
Mailing Address - City:ROCHESTER
Mailing Address - State:NY
Mailing Address - Zip Code:14642-0001
Mailing Address - Country:US
Mailing Address - Phone:585-275-7892
Mailing Address - Fax:585-482-1666
Practice Address - Street 1:7601 OSLER DR
Practice Address - Street 2:
Practice Address - City:TOWSON
Practice Address - State:MD
Practice Address - Zip Code:21204-7700
Practice Address - Country:US
Practice Address - Phone:410-337-1150
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-09
Last Update Date:2022-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001485367A00000X
MDR245446367A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367A00000XPhysician Assistants & Advanced Practice Nursing ProvidersAdvanced Practice Midwife
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYJ400074381Medicare PIN