Active NPI
Amanda Rae Jensen, FNP-BC
- Nurse Practitioner
- Hammond, IN
National Provider Identifier
1811575319
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 28186494A
- Practice address
- 7904 Cabela Dr
Hammond, IN 46324-2950 - Phone
- (219) 554-9911
- Fax
- (219) 554-9912
- NPI assigned
- Mar 29, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 28186494A | IN | Primary |
Addresses
Primary practice location
7904 Cabela Dr
Hammond, IN 46324-2950
Mailing address
11419 Georgia St
Crown Point, IN 46307-0035
Phone (219) 487-9062
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 28186494A | IN | MD | Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1616976000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1626048000000",
"number": "1811575319",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "11419 GEORGIA ST",
"city": "CROWN POINT",
"state": "IN",
"postal_code": "463070035",
"telephone_number": "219-487-9062"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "7904 CABELA DR",
"city": "HAMMOND",
"state": "IN",
"postal_code": "463242950",
"telephone_number": "219-554-9911",
"fax_number": "219-554-9912"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "AMANDA",
"middle_name": "RAE",
"credential": "FNP-BC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-03-29",
"last_updated": "2021-07-12",
"certification_date": "2021-07-12",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "IN",
"license": "28186494A",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hammond, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.