Individual provider Active NPI

Lynn Jensen, RN, MS, GNP

  • Registered Nurse
  • Greenfield, WI
National Provider Identifier
1386785343
Registry record updated Sep 29, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered NurseTaxonomy code 163W00000X
License
61743-030 Issued in WI
Practice address
5345 S Butterfield Way
Greenfield, WI 53221-3249
Phone
(414) 763-4195
NPI assigned
Feb 10, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 29, 2011

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Nurse 163W00000X 61743-030 WI Primary
Registered Nurse 163W00000X RN00094632 WA
Gerontology Registered Nurse 163WG0600X 2548-033 WI
Gerontology Registered Nurse 163WG0600X AP30002498 WA

Addresses

Primary practice location

5345 S Butterfield Way
Greenfield, WI 53221-3249

Mailing address

5345 S Butterfield Way
Greenfield, WI 53221-3249
Phone (414) 763-4195

Other identifiers 1

IdentifierTypeStateIssuer
9624636MedicaidWA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science, Nurse Practitioner, Registered Nurse

State licenses

LicenseStateTypeSpecialty
RN00094632WAMDRegistered Nurse
61743-030WIMDRegistered Nurse
AP30002498WAMDGerontology Registered Nurse
2548-033WIMDGerontology Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1317254400000",
    "number": "1386785343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5345 S BUTTERFIELD WAY",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532213249",
            "telephone_number": "414-763-4195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5345 S BUTTERFIELD WAY",
            "city": "GREENFIELD",
            "state": "WI",
            "postal_code": "532213249",
            "telephone_number": "414-763-4195"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "LYNN",
        "credential": "RN, MS, GNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-02-10",
        "last_updated": "2011-09-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WI",
            "license": "61743-030",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "WA",
            "license": "RN00094632",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "WI",
            "license": "2548-033",
            "primary": false
        },
        {
            "code": "163WG0600X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Gerontology",
            "state": "WA",
            "license": "AP30002498",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "9624636",
            "state": "WA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenfield, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.