Provider Demographics
NPI:1063985307
Name:JENSEN, KAREN E (RRT)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:E
Last Name:JENSEN
Suffix:
Gender:F
Credentials:RRT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:153 FARM LAKE RD
Mailing Address - Street 2:
Mailing Address - City:CAROLINA SHORES
Mailing Address - State:NC
Mailing Address - Zip Code:28467-3082
Mailing Address - Country:US
Mailing Address - Phone:908-246-8904
Mailing Address - Fax:
Practice Address - Street 1:153 FARM LAKE RD
Practice Address - Street 2:
Practice Address - City:CAROLINA SHORES
Practice Address - State:NC
Practice Address - Zip Code:28467-3082
Practice Address - Country:US
Practice Address - Phone:908-246-8904
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-01-09
Last Update Date:2019-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCA-9217227900000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes227900000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersRespiratory Therapist, Registered