Healthcare Provider Details

I. General information

NPI: 1386574721
Provider Name (Legal Business Name): KENDRA JENSEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/19/2026
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1020 W 18TH ST
SIOUX FALLS SD
57104-4707
US

IV. Provider business mailing address

1020 W 18TH ST
SIOUX FALLS SD
57104-4707
US

V. Phone/Fax

Practice location:
  • Phone: 605-444-9700
  • Fax: 605-444-9701
Mailing address:
  • Phone: 605-444-9700
  • Fax: 605-444-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code225100000X
TaxonomyPhysical Therapist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: