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General NPI Number Information
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NPI Number | 1902912827
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Entity Type | Individual
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Provider Name | ELIZABETH JENSEN APRN, DNP
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Gender | Female
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Dates
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Enumeration Date | 08/22/2006
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Last Update Date | 08/10/2016
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Provider Practice Location Address
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Address Line | 120 SIMSBURY RD STE B
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City | AVON
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State | CT
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Zip | 06001-3735
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Country | US
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Telephone | 860-674-0111
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Fax | 860-674-5406
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Provider Business Mailing Address
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Address Line | 120 SIMSBURY RD STE 12B
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City | AVON
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State | CT
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Zip | 06001-3735
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Country | US
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Telephone | 860-674-0111
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Fax | 860-674-5406
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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 | 364SW0102X
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Taxonomy Name | Women's Health Clinical Nurse Specialist
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License Number | 002310
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License Number State | CT
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Taxonomy #2
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Taxonomy Code | 363LX0001X
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Taxonomy Name | Obstetrics & Gynecology Nurse Practitioner
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License Number | 000189
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License Number State | CT
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