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General NPI Number Information
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NPI Number | 1154139905
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Entity Type | Individual
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Provider Name | KAEL JENSEN MA, BS, NBC-HWC, CMT
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Gender | Female
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Dates
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Enumeration Date | 12/26/2024
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Last Update Date | 12/26/2024
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Provider Practice Location Address
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Address Line | 12445 55TH ST N STE A
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City | LAKE ELMO
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State | MN
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Zip | 55042-7402
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Country | US
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Telephone | 651-442-1308
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Fax |
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Provider Business Mailing Address
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Address Line | 44 MILLER CREST LN
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City | SAINT PAUL
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State | MN
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Zip | 55106-6829
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Country | US
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Telephone | 651-442-1308
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number |
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License Number State |
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