Provider Demographics
NPI:1093520314
Name:JENSEN, JULIE BETH
Entity type:Individual
Prefix:
First Name:JULIE
Middle Name:BETH
Last Name:JENSEN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:519 DURHAM AVE
Mailing Address - Street 2:
Mailing Address - City:HATTON
Mailing Address - State:ND
Mailing Address - Zip Code:58240-4013
Mailing Address - Country:US
Mailing Address - Phone:307-575-0243
Mailing Address - Fax:
Practice Address - Street 1:519 DURHAM AVE
Practice Address - Street 2:
Practice Address - City:HATTON
Practice Address - State:ND
Practice Address - Zip Code:58240-4013
Practice Address - Country:US
Practice Address - Phone:307-575-0243
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-02-12
Last Update Date:2025-02-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care Attendant