Provider Demographics
NPI:1225848203
Name:JENSEN, STONEY
Entity type:Individual
Prefix:
First Name:STONEY
Middle Name:
Last Name:JENSEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 126
Mailing Address - Street 2:
Mailing Address - City:TROPIC
Mailing Address - State:UT
Mailing Address - Zip Code:84776-0126
Mailing Address - Country:US
Mailing Address - Phone:435-679-8710
Mailing Address - Fax:
Practice Address - Street 1:360 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:UT
Practice Address - Zip Code:84528-5512
Practice Address - Country:US
Practice Address - Phone:435-820-0574
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-01-10
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT0801L3416L0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes3416L0300XTransportation ServicesAmbulanceLand Transport