Healthcare Provider Details

I. General information

NPI: 1962051672
Provider Name (Legal Business Name): JENSEN SCHEELE-FOSTER PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: JENSEN NICOLE SCHEELE ATC

II. Dates (important events)

Enumeration Date: 09/05/2019
Last Update Date: 06/30/2026
Certification Date: 06/30/2026
Deactivation Date: 05/11/2026
Reactivation Date: 06/24/2026

III. Provider practice location address

1620 CHARLES PL
MANHATTAN KS
66502-2750
US

IV. Provider business mailing address

1613 VIRGINIA DR
MANHATTAN KS
66502-2337
US

V. Phone/Fax

Practice location:
  • Phone: 785-776-1400
  • Fax:
Mailing address:
  • Phone: 785-713-2410
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: