Healthcare Provider Details

I. General information

NPI: 1588873145
Provider Name (Legal Business Name): RHONDA R JENSEN CNS
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: RHONDA R KNUDSEN CNS

II. Dates (important events)

Enumeration Date: 05/21/2007
Last Update Date: 04/25/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1305 W 18TH ST
SIOUX FALLS SD
57105-0401
US

IV. Provider business mailing address

PO BOX 5074
SIOUX FALLS SD
57117-5074
US

V. Phone/Fax

Practice location:
  • Phone: 605-328-6147
  • Fax:
Mailing address:
  • Phone: 605-328-9700
  • Fax: 605-328-9701

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WD0400X
TaxonomyDiabetes Educator Registered Nurse
License Number105132
License Number StateIA
# 2
Primary TaxonomyY
Taxonomy Code364S00000X
TaxonomyClinical Nurse Specialist
License NumberCS004025
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: