Provider Demographics
NPI:1447972823
Name:JENSEN, KRISTIN RENEE (MSN, APRN, FNP-C)
Entity type:Individual
Prefix:
First Name:KRISTIN
Middle Name:RENEE
Last Name:JENSEN
Suffix:
Gender:F
Credentials:MSN, APRN, FNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:W5829 HOELZEL WAY
Mailing Address - Street 2:
Mailing Address - City:APPLETON
Mailing Address - State:WI
Mailing Address - Zip Code:54915-5301
Mailing Address - Country:US
Mailing Address - Phone:630-768-4723
Mailing Address - Fax:
Practice Address - Street 1:W5829 HOELZEL WAY
Practice Address - Street 2:
Practice Address - City:APPLETON
Practice Address - State:WI
Practice Address - Zip Code:54915-5301
Practice Address - Country:US
Practice Address - Phone:630-768-4723
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-13
Last Update Date:2022-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI12071-33363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily