Provider Demographics
NPI:1043294911
Name:POINDEXTER, HELEN WYLIE (FAMILY NURSE PRACTIT)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:WYLIE
Last Name:POINDEXTER
Suffix:
Gender:F
Credentials:FAMILY NURSE PRACTIT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1247 NE MEDICAL CENTER DR
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97701-3786
Mailing Address - Country:US
Mailing Address - Phone:541-389-7741
Mailing Address - Fax:541-388-3832
Practice Address - Street 1:18 NW OREGON AVE
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97701-2729
Practice Address - Country:US
Practice Address - Phone:541-389-7741
Practice Address - Fax:541-388-3832
Is Sole Proprietor?:No
Enumeration Date:2005-12-02
Last Update Date:2007-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR087003360N1363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR240320Medicaid
OR240320Medicaid
ORS84398Medicare UPIN