Provider Demographics
NPI:1588643571
Name:VANSANT, HELEN BROGAN (APRN)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:BROGAN
Last Name:VANSANT
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2201 BOUNDARY ST STE 112
Mailing Address - Street 2:
Mailing Address - City:BEAUFORT
Mailing Address - State:SC
Mailing Address - Zip Code:29902-3879
Mailing Address - Country:US
Mailing Address - Phone:877-202-2869
Mailing Address - Fax:
Practice Address - Street 1:2201 BOUNDARY ST STE 112
Practice Address - Street 2:
Practice Address - City:BEAUFORT
Practice Address - State:SC
Practice Address - Zip Code:29902-3879
Practice Address - Country:US
Practice Address - Phone:877-202-2869
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-01-10
Last Update Date:2024-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DELG-0000310363LF0000X
MDR097778363LF0000X
SC18588363LF0000X
SC54-18588363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD9055060OtherAETNA HMO AND PPO
MD01661796OtherAMERIGROUP
MDP865-0003OtherCAREFIRST
MD699036300Medicaid
MD037111OtherJHHC PRODUCTS
PO8979Medicare UPIN
621LD786Medicare PIN
MDP865-0003OtherCAREFIRST