Provider Demographics
NPI:1598763989
Name:MCNICHOLAS, HELEN S (RN, CS, FNP)
Entity Type:Individual
Prefix:MS
First Name:HELEN
Middle Name:S
Last Name:MCNICHOLAS
Suffix:
Gender:F
Credentials:RN, CS, FNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8307 E NEVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85208-6730
Mailing Address - Country:US
Mailing Address - Phone:480-984-2863
Mailing Address - Fax:
Practice Address - Street 1:8307 E NEVILLE AVE
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85208-6730
Practice Address - Country:US
Practice Address - Phone:480-984-2863
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-07-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZRN099009101YM0800X, 363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Not Answered363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily