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NPI Code Detail

MEDICARE: DR. ASHLEY LYNN JANSEN DNP, APN, PMHNP-BC

MEDICARE: DR. ASHLEY LYNN JANSEN DNP, APN, PMHNP-BC
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
1363LP0808XPsychiatric/Mental Health Nurse PractitionerCP001307SD

General Provider Information

NPI Number : 1124530860
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. ASHLEY LYNN JANSEN DNP, APN, PMHNP-BC
Provider Business Mailing Address
First Line : 4500 N LEWIS AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-7111
Country : US
Telephone Number : 605-322-2980
Fax Number :
Provider Business Practice Location Address
First Line : 4510 N LEWIS AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57104-7111
Country : US
Telephone Number : 605-322-6368
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/03/2017
Last Update Date : 04/26/2019

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