Provider Demographics
NPI:1235320854
Name:HABTEMICHAEL, HELEN (WHNP-C)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:HABTEMICHAEL
Suffix:
Gender:F
Credentials:WHNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11551 NUCKOLS RD
Mailing Address - Street 2:SUITE C
Mailing Address - City:GLEN ALLEN
Mailing Address - State:VA
Mailing Address - Zip Code:23059-5565
Mailing Address - Country:US
Mailing Address - Phone:804-888-6800
Mailing Address - Fax:804-888-6804
Practice Address - Street 1:11551 NUCKOLS RD
Practice Address - Street 2:SUITE C
Practice Address - City:GLEN ALLEN
Practice Address - State:VA
Practice Address - Zip Code:23059-5565
Practice Address - Country:US
Practice Address - Phone:804-888-6800
Practice Address - Fax:804-888-6804
Is Sole Proprietor?:No
Enumeration Date:2007-08-08
Last Update Date:2015-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0024167330363LW0102X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LW0102XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerWomen's Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY016747R82Medicare PIN