Provider Demographics
NPI:1659670222
Name:HELMS, KENDALL WAYNE JR (ARNP)
Entity Type:Individual
Prefix:MR
First Name:KENDALL
Middle Name:WAYNE
Last Name:HELMS
Suffix:JR
Gender:M
Credentials:ARNP
Other - Prefix:MR
Other - First Name:KEN
Other - Middle Name:W
Other - Last Name:HELMS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:ARNP
Mailing Address - Street 1:633 E BALDWIN RD
Mailing Address - Street 2:
Mailing Address - City:PANAMA CITY
Mailing Address - State:FL
Mailing Address - Zip Code:32405-4207
Mailing Address - Country:US
Mailing Address - Phone:850-522-5490
Mailing Address - Fax:850-522-5491
Practice Address - Street 1:3 MEDICAL PARK
Practice Address - Street 2:
Practice Address - City:FAIRHOPE
Practice Address - State:AL
Practice Address - Zip Code:36532-1804
Practice Address - Country:US
Practice Address - Phone:251-929-3058
Practice Address - Fax:251-929-3067
Is Sole Proprietor?:Yes
Enumeration Date:2011-03-22
Last Update Date:2018-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-082539363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily