Provider Demographics
NPI:1265032106
Name:HELTON, KRISTEN NICOLE (NP-BC)
Entity Type:Individual
Prefix:
First Name:KRISTEN
Middle Name:NICOLE
Last Name:HELTON
Suffix:
Gender:F
Credentials:NP-BC
Other - Prefix:
Other - First Name:KRISTEN
Other - Middle Name:NICOLE
Other - Last Name:WILSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:976 LC POPE RD
Mailing Address - Street 2:
Mailing Address - City:EAST DUBLIN
Mailing Address - State:GA
Mailing Address - Zip Code:31027-1648
Mailing Address - Country:US
Mailing Address - Phone:229-315-8649
Mailing Address - Fax:
Practice Address - Street 1:654 COUNTY FARM RD
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:GA
Practice Address - Zip Code:31021-1799
Practice Address - Country:US
Practice Address - Phone:478-272-2051
Practice Address - Fax:478-275-6517
Is Sole Proprietor?:No
Enumeration Date:2020-10-29
Last Update Date:2020-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN228241363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily