Provider Demographics
NPI:1528333416
Name:JENSEN, BRANDON LOUIS (FNP-C)
Entity type:Individual
Prefix:MR
First Name:BRANDON
Middle Name:LOUIS
Last Name:JENSEN
Suffix:
Gender:M
Credentials:FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1459
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55440-1459
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1600 7TH AVE STE 110
Practice Address - Street 2:
Practice Address - City:SEATTLE
Practice Address - State:WA
Practice Address - Zip Code:98101-2288
Practice Address - Country:US
Practice Address - Phone:888-663-6331
Practice Address - Fax:415-291-0489
Is Sole Proprietor?:No
Enumeration Date:2012-03-12
Last Update Date:2021-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN8005363L00000X
HIAPRN-2508363L00000X
AZAP11432363L00000X
ID59291363L00000X
NVNP811888363L00000X
UT10851422-4405363L00000X
NM62283363L00000X
NDR49765363L00000X
SDCP001859363L00000X
COC-APN.0002182-C-NP363L00000X
NE113334363L00000X
IAA161042363L00000X
CA22236363LF0000X
OR201400610NP-PP363LF0000X
WAAP60863432363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
No363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily