MEDICARE: DR. SHAWN EDWARD JENSEN PHARMD, RPH

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	183500000X	Pharmacist	20215	NV

General Provider Information

NPI Number	:	1427699792
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SHAWN EDWARD JENSEN PHARMD, RPH

Provider Business Mailing Address
First Line	:	2855 S NELLIS BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7505
Country	:	US
Telephone Number	:	702-431-4193
Fax Number	:

Provider Business Practice Location Address
First Line	:	2855 S NELLIS BLVD
Second Line	:
City	:	LAS VEGAS
State	:	NV
Zip	:	89121-7505
Country	:	US
Telephone Number	:	702-431-4193
Fax Number	:

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

Provider Enumeration Date	:	10/08/2019
Last Update Date	:	07/22/2024

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