Provider Demographics
NPI:1073264453
Name:HELLAND, KIRSTEN JEAN
Entity Type:Individual
Prefix:
First Name:KIRSTEN
Middle Name:JEAN
Last Name:HELLAND
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:PO BOX 12
Mailing Address - Street 2:
Mailing Address - City:DRAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58736-0012
Mailing Address - Country:US
Mailing Address - Phone:701-537-3267
Mailing Address - Fax:
Practice Address - Street 1:1062 34TH ST NE
Practice Address - Street 2:
Practice Address - City:DRAKE
Practice Address - State:ND
Practice Address - Zip Code:58736-9494
Practice Address - Country:US
Practice Address - Phone:701-537-3267
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-01-17
Last Update Date:2022-01-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes3747P1801XNursing Service Related ProvidersTechnicianPersonal Care AttendantGroup - Single Specialty