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General NPI Number Information
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NPI Number | 1619208444
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Entity Type | Individual
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Provider Name | SHAWN JENSEN R.N., CPNP
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Gender | Female
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Dates
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Enumeration Date | 01/19/2010
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Last Update Date | 10/12/2022
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Provider Practice Location Address
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Address Line | 4855 S MOORLAND RD STE 250
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City | NEW BERLIN
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State | WI
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Zip | 53151-7494
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Country | US
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Telephone | 262-789-6020
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Fax | 262-789-6025
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Provider Business Mailing Address
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Address Line | 1320 CARDINAL DR
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City | OCONOMOWOC
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State | WI
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Zip | 53066-2383
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Country | US
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Telephone | 262-893-7641
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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 | 163WP0200X
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Taxonomy Name | Pediatric Registered Nurse
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License Number | 161673-30
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License Number State | WI
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Taxonomy #2
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Taxonomy Code | 363LP0200X
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Taxonomy Name | Pediatric Nurse Practitioner
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License Number | 13131-33
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License Number State | WI
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