Provider Demographics
NPI:1093258568
Name:KPAKOLO, HELEN KPALAGA (RN)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:KPALAGA
Last Name:KPAKOLO
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:23A CIRCUIT AVE E
Mailing Address - Street 2:
Mailing Address - City:WORCESTER
Mailing Address - State:MA
Mailing Address - Zip Code:01603-2150
Mailing Address - Country:US
Mailing Address - Phone:774-633-1974
Mailing Address - Fax:
Practice Address - Street 1:23A CIRCUIT AVE E
Practice Address - Street 2:
Practice Address - City:WORCESTER
Practice Address - State:MA
Practice Address - Zip Code:01603-2150
Practice Address - Country:US
Practice Address - Phone:774-633-1974
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-11-30
Last Update Date:2016-11-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MARN2273993163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse