Provider Demographics
NPI:1235313834
Name:GENSHEIMER, HELENE M (APN)
Entity Type:Individual
Prefix:
First Name:HELENE
Middle Name:M
Last Name:GENSHEIMER
Suffix:
Gender:F
Credentials:APN
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 429
Mailing Address - Street 2:175 VOLUNTEER PARKWAY
Mailing Address - City:CLINTON
Mailing Address - State:AR
Mailing Address - Zip Code:72031-0429
Mailing Address - Country:US
Mailing Address - Phone:501-745-3033
Mailing Address - Fax:501-745-8099
Practice Address - Street 1:1605 W FRANK AVE
Practice Address - Street 2:
Practice Address - City:LUFKIN
Practice Address - State:TX
Practice Address - Zip Code:75904-3103
Practice Address - Country:US
Practice Address - Phone:936-634-9233
Practice Address - Fax:906-634-9353
Is Sole Proprietor?:No
Enumeration Date:2007-12-19
Last Update Date:2009-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX593160363L00000X
ARA01602363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner