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NPI Code Detail

MEDICARE: MRS. DEBORAH J JENSEN

MEDICARE: MRS. DEBORAH J 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
1164X00000XLicensed Vocational Nurse155482TX

General Provider Information

NPI Number : 1467098103
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DEBORAH J JENSEN
Provider Business Mailing Address
First Line : 7662 ARCADIA TRL
Second Line :
City : FORT WORTH
State : TX
Zip : 76137-3534
Country : US
Telephone Number : 817-271-0070
Fax Number :
Provider Business Practice Location Address
First Line : 7662 ARCADIA TRL
Second Line :
City : FORT WORTH
State : TX
Zip : 76137-3534
Country : US
Telephone Number : 817-271-0070
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/18/2019
Last Update Date : 11/18/2019

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Directions to “ MRS. DEBORAH J JENSEN ” Practice Location

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