Healthcare Provider Details

I. General information

NPI: 1770406027
Provider Name (Legal Business Name): SANDRA L JENSEN RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/03/2026
Last Update Date: 08/03/2026
Certification Date: 08/03/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2883 W VICTORIAN DR
RIVERTON UT
84065-7616
US

IV. Provider business mailing address

4050 PIEDMONT PKWY
HIGH POINT NC
27265-9458
US

V. Phone/Fax

Practice location:
  • Phone: 435-881-3395
  • Fax:
Mailing address:
  • Phone: 336-289-8648
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number201801831RN
License Number StateOR
# 2
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number128846
License Number StateAK
# 3
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number95158257
License Number StateCA
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN1047468
License Number StateDC
# 5
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number88735
License Number StateHI
# 6
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number041464065
License Number StateIL
# 7
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN2323346
License Number StateMA
# 8
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number4704340133
License Number StateMI
# 9
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number2462292
License Number StateMN
# 10
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License NumberRN97320
License Number StateNV
# 11
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number744270
License Number StateNY
# 12
Primary TaxonomyY
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number218528-3102
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: