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General NPI Number Information
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NPI Number | 1912502972
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Entity Type | Individual
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Provider Name | KRISTIN MARIE JENSEN PTA
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Gender | Female
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Dates
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Enumeration Date | 11/30/2020
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Last Update Date | 12/27/2025
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Provider Practice Location Address
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Address Line | 721 TILGHMAN DR STE 200
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City | DUNN
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State | NC
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Zip | 28334-6066
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Country | US
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Telephone | 910-892-5635
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Fax |
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Provider Business Mailing Address
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Address Line | 5335 S VALENTIA WAY APT 440
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City | GREENWOOD VILLAGE
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State | CO
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Zip | 80111-3128
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Country | US
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Telephone | 719-722-8390
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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 | 225200000X
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Taxonomy Name | Physical Therapy Assistant
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License Number | 0014905
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License Number State | CO
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