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NPI Code Detail

MEDICARE: EMMA ANNE JENSEN

MEDICARE: EMMA ANNE 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
1172V00000XCommunity Health Worker

General Provider Information

NPI Number : 1992408769
Entity Type Code : Individual
Provider Name (Legal Business Name) : EMMA ANNE JENSEN
Provider Business Mailing Address
First Line : 4460 S HIGHLAND DR STE 120
Second Line :
City : SALT LAKE CITY
State : UT
Zip : 84124-3550
Country : US
Telephone Number : 888-949-4864
Fax Number :
Provider Business Practice Location Address
First Line : 6232 S 900 E
Second Line :
City : MURRAY
State : UT
Zip : 84121-2471
Country : US
Telephone Number : 801-784-5972
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/22/2023
Last Update Date : 03/22/2023

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Directions to “ EMMA ANNE JENSEN ” Practice Location

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