MEDICARE: CHRIS JENSEN ARNP

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	363LF0000X	Family Nurse Practitioner	2945432	FL

General Provider Information

NPI Number	:	1184062069
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CHRIS JENSEN ARNP

Provider Business Mailing Address
First Line	:	2000 HARTMAN RD STE 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4412
Country	:	US
Telephone Number	:	772-465-1170
Fax Number	:

Provider Business Practice Location Address
First Line	:	2000 HARTMAN RD STE 1
Second Line	:
City	:	FORT PIERCE
State	:	FL
Zip	:	34947-4412
Country	:	US
Telephone Number	:	772-465-1170
Fax Number	:

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

Provider Enumeration Date	:	06/12/2013
Last Update Date	:	07/21/2022

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