Provider Demographics
NPI:1982396669
Name:JENSEN, CHLOE ANSMARIE (MD)
Entity Type:Individual
Prefix:
First Name:CHLOE
Middle Name:ANSMARIE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:CHLOE
Other - Middle Name:ANSMARIE
Other - Last Name:EDWARDS VAN MUIJEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST STOP 8312
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-8312
Mailing Address - Country:US
Mailing Address - Phone:806-743-2370
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST STOP 8312
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-8312
Practice Address - Country:US
Practice Address - Phone:806-743-2370
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-05-22
Last Update Date:2023-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program