Provider Demographics
NPI:1215674106
Name:JENSEN, SUZANA MARIE (DO)
Entity type:Individual
Prefix:DR
First Name:SUZANA
Middle Name:MARIE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:SUZANA
Other - Middle Name:MARIE
Other - Last Name:SIGNAIGO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3601 4TH ST STOP 9406
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79430-9406
Mailing Address - Country:US
Mailing Address - Phone:806-743-7337
Mailing Address - Fax:
Practice Address - Street 1:3601 4TH ST STOP 9406
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79430-9406
Practice Address - Country:US
Practice Address - Phone:806-743-7337
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-12
Last Update Date:2022-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program