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General NPI Number Information
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NPI Number | 1760011134
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Entity Type | Individual
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Provider Name | JOANNE JENSEN PHARMD
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Gender | Female
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Dates
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Enumeration Date | 04/07/2020
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Last Update Date | 04/07/2020
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Provider Practice Location Address
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Address Line | 1115 N SUMMIT ST
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City | CRESCENT CITY
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State | FL
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Zip | 32112-1721
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Country | US
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Telephone | 386-698-4922
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Fax | 386-698-4903
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Provider Business Mailing Address
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Address Line | 11 CLEVELAND CT
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City | PALM COAST
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State | FL
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Zip | 32137-8925
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Country | US
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Telephone | 727-204-7383
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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 | 183500000X
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Taxonomy Name | Pharmacist
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License Number | PS34895
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License Number State | FL
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