MEDICARE: LUKE JENSEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist	158350	NE

General Provider Information

NPI Number	:	1063369122
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LUKE JENSEN

Provider Business Mailing Address
First Line	:	16359 WEIR ST
Second Line	:
City	:	OMAHA
State	:	NE
Zip	:	68135-1217
Country	:	US
Telephone Number	:	915-202-4402
Fax Number	:

Provider Business Practice Location Address
First Line	:	2500 ROCKY MOUNTAIN AVE
Second Line	:
City	:	LOVELAND
State	:	CO
Zip	:	80538-9004
Country	:	US
Telephone Number	:	915-202-4402
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/16/2026
Last Update Date	:	03/16/2026

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Directions to “ LUKE JENSEN ” Practice Location

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