MEDICARE: JOANNA 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	ARNP1568722	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	ARNP1568722	OTHER	FL	LICENSE- ARNP - FAMILY

General Provider Information

NPI Number	:	1316902034
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOANNA JENSEN ARNP

Provider Business Mailing Address
First Line	:	1555 US HIGHWAY 1 STE 105
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-4728
Country	:	US
Telephone Number	:	772-257-8224
Fax Number	:	772-571-1602

Provider Business Practice Location Address
First Line	:	1555 US HIGHWAY 1 STE 105
Second Line	:
City	:	VERO BEACH
State	:	FL
Zip	:	32960-4728
Country	:	US
Telephone Number	:	772-257-8224
Fax Number	:	772-571-1602

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

Provider Enumeration Date	:	04/18/2006
Last Update Date	:	12/05/2014

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