Healthcare Provider Details

I. General information

NPI: 1508853557
Provider Name (Legal Business Name): REBECCA JENSON MSN, APRN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/04/2005
Last Update Date: 03/18/2026
Certification Date: 03/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

247 W 12300 S STE C
DRAPER UT
84020-8158
US

IV. Provider business mailing address

247 W 12300 S STE C
DRAPER UT
84020-8158
US

V. Phone/Fax

Practice location:
  • Phone: 801-859-9633
  • Fax: 385-393-5778
Mailing address:
  • Phone: 801-859-9633
  • Fax: 385-393-5778

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LP2300X
TaxonomyPrimary Care Nurse Practitioner
License Number214219-4405
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: