Provider Demographics
NPI:1578794608
Name:HELMS, WHITNEY M (APRN, CPNP)
Entity Type:Individual
Prefix:
First Name:WHITNEY
Middle Name:M
Last Name:HELMS
Suffix:
Gender:F
Credentials:APRN, CPNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2910 SHED RD
Mailing Address - Street 2:
Mailing Address - City:BOSSIER CITY
Mailing Address - State:LA
Mailing Address - Zip Code:71111-3154
Mailing Address - Country:US
Mailing Address - Phone:318-747-0540
Mailing Address - Fax:318-741-5700
Practice Address - Street 1:2910 SHED RD
Practice Address - Street 2:
Practice Address - City:BOSSIER CITY
Practice Address - State:LA
Practice Address - Zip Code:71111-3154
Practice Address - Country:US
Practice Address - Phone:318-747-0540
Practice Address - Fax:318-741-5700
Is Sole Proprietor?:Yes
Enumeration Date:2009-08-06
Last Update Date:2013-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA05836363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1889709Medicaid