Provider Demographics
NPI:1972367340
Name:ASCENT CARE
Entity type:Organization
Organization Name:ASCENT CARE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:NURSE PRACTITIONER
Authorized Official - Prefix:
Authorized Official - First Name:LISA
Authorized Official - Middle Name:
Authorized Official - Last Name:JENSEN
Authorized Official - Suffix:
Authorized Official - Credentials:NP
Authorized Official - Phone:208-735-2273
Mailing Address - Street 1:1201 FALLS AVE E STE 32
Mailing Address - Street 2:
Mailing Address - City:TWIN FALLS
Mailing Address - State:ID
Mailing Address - Zip Code:83301-3465
Mailing Address - Country:US
Mailing Address - Phone:208-735-2273
Mailing Address - Fax:208-735-2276
Practice Address - Street 1:1201 FALLS AVE E STE 32
Practice Address - Street 2:
Practice Address - City:TWIN FALLS
Practice Address - State:ID
Practice Address - Zip Code:83301-3465
Practice Address - Country:US
Practice Address - Phone:208-650-9922
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-02-07
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QH0100XAmbulatory Health Care FacilitiesClinic/CenterHealth Service