Provider Demographics
NPI:1932539855
Name:JENSEN, KRISTI (RNFA)
Entity Type:Individual
Prefix:
First Name:KRISTI
Middle Name:
Last Name:JENSEN
Suffix:
Gender:F
Credentials:RNFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:564 N CLARK ST
Mailing Address - Street 2:
Mailing Address - City:POWELL
Mailing Address - State:WY
Mailing Address - Zip Code:82435-1916
Mailing Address - Country:US
Mailing Address - Phone:307-254-0599
Mailing Address - Fax:
Practice Address - Street 1:564 N CLARK ST
Practice Address - Street 2:
Practice Address - City:POWELL
Practice Address - State:WY
Practice Address - Zip Code:82435-1916
Practice Address - Country:US
Practice Address - Phone:307-254-0599
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-11-13
Last Update Date:2013-11-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WY23621163WR0006X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WR0006XNursing Service ProvidersRegistered NurseRegistered Nurse First Assistant