Provider Demographics
NPI:1467521476
Name:HELMER, JENNIFER EILEEN (LPN)
Entity Type:Individual
Prefix:MRS
First Name:JENNIFER
Middle Name:EILEEN
Last Name:HELMER
Suffix:
Gender:F
Credentials:LPN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1455 COUNTY ROUTE 53
Mailing Address - Street 2:
Mailing Address - City:OSWEGO
Mailing Address - State:NY
Mailing Address - Zip Code:13126-6117
Mailing Address - Country:US
Mailing Address - Phone:315-342-9397
Mailing Address - Fax:
Practice Address - Street 1:1455 COUNTY ROUTE 53
Practice Address - Street 2:
Practice Address - City:OSWEGO
Practice Address - State:NY
Practice Address - Zip Code:13126-6117
Practice Address - Country:US
Practice Address - Phone:315-342-9397
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-06
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY255711-1164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY01954012Medicaid