Provider Demographics
NPI:1619947462
Name:HELTON, JENNIFER LEIGH (MD)
Entity Type:Individual
Prefix:DR
First Name:JENNIFER
Middle Name:LEIGH
Last Name:HELTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13557 STEELECROFT PKWY
Mailing Address - Street 2:SUITE 2500
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28278-7550
Mailing Address - Country:US
Mailing Address - Phone:704-587-3200
Mailing Address - Fax:704-587-0044
Practice Address - Street 1:13557 STEELECROFT PKWY
Practice Address - Street 2:SUITE 2500
Practice Address - City:CHARLOTTE
Practice Address - State:NC
Practice Address - Zip Code:28278-7550
Practice Address - Country:US
Practice Address - Phone:704-587-3200
Practice Address - Fax:704-587-0044
Is Sole Proprietor?:No
Enumeration Date:2006-01-24
Last Update Date:2016-04-08
Deactivation Date:2006-01-24
Deactivation Code:
Reactivation Date:2006-01-26
Provider Licenses
StateLicense IDTaxonomies
NC9400526207N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207N00000XAllopathic & Osteopathic PhysiciansDermatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC10308OtherBCBS OF NORTH CAROLINA
NCNCB710C304Medicare PIN
NCF94542Medicare UPIN