Provider Demographics
NPI:1992147649
Name:JENSEN, CHRISTINE MARIE (PHARMD)
Entity type:Individual
Prefix:MRS
First Name:CHRISTINE
Middle Name:MARIE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:PHARMD
Other - Prefix:
Other - First Name:CHRISTINE
Other - Middle Name:MARIE
Other - Last Name:SOUKUP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2840 SYRACUSE CT
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80238-2454
Mailing Address - Country:US
Mailing Address - Phone:970-481-8057
Mailing Address - Fax:
Practice Address - Street 1:16910 E QUINCY AVE
Practice Address - Street 2:T0256
Practice Address - City:AURORA
Practice Address - State:CO
Practice Address - Zip Code:80015-2745
Practice Address - Country:US
Practice Address - Phone:303-680-3284
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-23
Last Update Date:2013-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO0019824183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist