Provider Demographics
NPI:1508181553
Name:TUNCAP, HELENE DUENAS (PA-C)
Entity Type:Individual
Prefix:
First Name:HELENE
Middle Name:DUENAS
Last Name:TUNCAP
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:HELENE
Other - Middle Name:ANNE
Other - Last Name:DUENAS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PA-C
Mailing Address - Street 1:374 PALE SAN VITORES RD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:TAMUNING
Mailing Address - State:GU
Mailing Address - Zip Code:96913-4082
Mailing Address - Country:US
Mailing Address - Phone:671-686-2175
Mailing Address - Fax:
Practice Address - Street 1:548 S MARINE CORPS DR
Practice Address - Street 2:
Practice Address - City:TAMUNING
Practice Address - State:GU
Practice Address - Zip Code:96913-3539
Practice Address - Country:US
Practice Address - Phone:671-646-5825
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-04-01
Last Update Date:2015-06-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
GUPA-86363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program