Emmeron West Jensen
Student in an Organized Health Care Education/Training Program in Dayton, OH. Individual provider (NPI-1).
NPI number1104779909
StatusActive
Last updated in NPPESFeb 19, 2026
Details
- NPI
- 1104779909
- Entity type
- Individual (NPI-1)
- Name
- Emmeron West Jensen
- Sex
- Male
- Sole proprietor
- Yes
- Enumeration date
- Feb 19, 2026
- Certification date
- Feb 19, 2026
- Last updated
- Feb 19, 2026
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 390200000X | Student in an Organized Health Care Education/Training Program | 48G75015379 | OH | Yes |
Practice location
1622 John Glenn RdDayton, OH 45410-3221
Phone 801-404-4241
Mailing address
1622 John Glenn RdDayton, OH 45410-3221
Phone 801-404-4241
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