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General NPI Number Information
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NPI Number | 1447053319
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Entity Type | Individual
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Provider Name | TRINTIY JENSEN
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Gender | Female
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Dates
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Enumeration Date | 03/28/2025
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Last Update Date | 03/28/2025
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Provider Practice Location Address
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Address Line | 1906 DUNBAR DR
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City | PLATTSMOUTH
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State | NE
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Zip | 68048-3808
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Country | US
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Telephone | 402-505-2931
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Fax |
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Provider Business Mailing Address
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Address Line | 1520 ROCK BLUFF RD
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City | PLATTSMOUTH
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State | NE
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Zip | 68048-4293
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Country | US
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Telephone | 402-505-2931
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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 | 251C00000X
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Taxonomy Name | Developmentally Disabled Services Day Training Agency
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License Number | 20027713
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License Number State | NE
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