Provider Demographics
NPI:1619391364
Name:ANDERSON, HELEN (FNPC)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:ANDERSON
Suffix:
Gender:F
Credentials:FNPC
Other - Prefix:
Other - First Name:HELEN
Other - Middle Name:
Other - Last Name:HICKS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:7749 W 600 N
Mailing Address - Street 2:
Mailing Address - City:FAIR OAKS
Mailing Address - State:IN
Mailing Address - Zip Code:47943-8520
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:520 8TH AVE NE
Practice Address - Street 2:
Practice Address - City:DEMOTTE
Practice Address - State:IN
Practice Address - Zip Code:46310-9108
Practice Address - Country:US
Practice Address - Phone:219-987-3581
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-02-14
Last Update Date:2020-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
INF1113319363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily