Elliot Jensen, DO
Student in an Organized Health Care Education/Training Program in Phoenix, AZ. Individual provider (NPI-1).
NPI number1043004591
StatusActive
Last updated in NPPESApr 8, 2025
Details
- NPI
- 1043004591
- Entity type
- Individual (NPI-1)
- Name
- Elliot Jensen
- Credential
- DO
- Sex
- Male
- Sole proprietor
- No
- Enumeration date
- Apr 8, 2025
- Certification date
- Apr 8, 2025
- Last updated
- Apr 8, 2025
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | – | – | Yes |
Practice location
2601 E Roosevelt StPhoenix, AZ 85008-4973
Phone 815-441-0823
Mailing address
3100 N Central AvePhoenix, AZ 85012-2637
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