Provider Demographics
NPI:1962374397
Name:STENSURD, JENEL
Entity type:Individual
Prefix:
First Name:JENEL
Middle Name:
Last Name:STENSURD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:12939 N CAMINO VIEJA RANCHERIA
Mailing Address - Street 2:
Mailing Address - City:ORO VALLEY
Mailing Address - State:AZ
Mailing Address - Zip Code:85755-5983
Mailing Address - Country:US
Mailing Address - Phone:480-209-4441
Mailing Address - Fax:
Practice Address - Street 1:12939 N CAMINO VIEJA RANCHERIA
Practice Address - Street 2:
Practice Address - City:ORO VALLEY
Practice Address - State:AZ
Practice Address - Zip Code:85755-5983
Practice Address - Country:US
Practice Address - Phone:480-209-4441
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-23
Last Update Date:2025-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ921421133V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, Registered