Provider Demographics
NPI:1548601610
Name:JENSEN, VICKI C (ARNP)
Entity type:Individual
Prefix:
First Name:VICKI
Middle Name:C
Last Name:JENSEN
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 HAWKINS DR
Mailing Address - Street 2:
Mailing Address - City:IOWA CITY
Mailing Address - State:IA
Mailing Address - Zip Code:52242-1009
Mailing Address - Country:US
Mailing Address - Phone:319-337-5997
Mailing Address - Fax:319-358-2665
Practice Address - Street 1:201 S CLINTON ST STE 168
Practice Address - Street 2:
Practice Address - City:IOWA CITY
Practice Address - State:IA
Practice Address - Zip Code:52240-4034
Practice Address - Country:US
Practice Address - Phone:319-384-0520
Practice Address - Fax:319-467-8105
Is Sole Proprietor?:No
Enumeration Date:2013-07-17
Last Update Date:2024-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IAA093694363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily