Provider Demographics
NPI:1285060004
Name:JENSEN, JAIME LOUISE (NP)
Entity type:Individual
Prefix:
First Name:JAIME
Middle Name:LOUISE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:JAIME
Other - Middle Name:LOUIS
Other - Last Name:JENSEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:721 E COURT ST
Mailing Address - Street 2:
Mailing Address - City:PARIS
Mailing Address - State:IL
Mailing Address - Zip Code:61944-2460
Mailing Address - Country:US
Mailing Address - Phone:217-465-4141
Mailing Address - Fax:217-465-5615
Practice Address - Street 1:727 E COURT ST
Practice Address - Street 2:
Practice Address - City:PARIS
Practice Address - State:IL
Practice Address - Zip Code:61944-2460
Practice Address - Country:US
Practice Address - Phone:217-465-8411
Practice Address - Fax:217-463-3184
Is Sole Proprietor?:No
Enumeration Date:2013-09-25
Last Update Date:2024-07-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL209010724363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
IL2013005851OtherANCC CERTIFICATION