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General NPI Number Information
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NPI Number | 1225848203
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Entity Type | Individual
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Provider Name | STONEY JENSEN
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Gender | Male
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Dates
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Enumeration Date | 01/10/2025
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Last Update Date | 01/10/2025
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Provider Practice Location Address
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Address Line | 360 N MAIN ST
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City | HUNTINGTON
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State | UT
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Zip | 84528-5512
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Country | US
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Telephone | 435-820-0574
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 126
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City | TROPIC
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State | UT
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Zip | 84776-0126
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Country | US
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Telephone | 435-679-8710
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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 | 3416L0300X
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Taxonomy Name | Land Ambulance
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License Number | 0801L
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License Number State | UT
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