Provider Demographics
NPI:1093513574
Name:JENSEN, PATRICIA ANN
Entity type:Individual
Prefix:
First Name:PATRICIA
Middle Name:ANN
Last Name:JENSEN
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4601 S 1ST ST TRLR 9
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:NE
Mailing Address - Zip Code:68701-5790
Mailing Address - Country:US
Mailing Address - Phone:402-649-7176
Mailing Address - Fax:
Practice Address - Street 1:4601 S 1ST ST TRLR 9
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:NE
Practice Address - Zip Code:68701-5790
Practice Address - Country:US
Practice Address - Phone:402-649-7176
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-03
Last Update Date:2025-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE385H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes385H00000XRespite Care FacilityRespite Care