Provider Demographics
NPI:1689734287
Name:HELMS, SANDRA L (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:L
Last Name:HELMS
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3700 WILLIAMS DRIVE
Mailing Address - Street 2:
Mailing Address - City:MARIANNA
Mailing Address - State:FL
Mailing Address - Zip Code:32446
Mailing Address - Country:US
Mailing Address - Phone:850-482-9222
Mailing Address - Fax:850-718-0434
Practice Address - Street 1:3700 WILLIAMS DRIVE
Practice Address - Street 2:
Practice Address - City:MARIANNA
Practice Address - State:FL
Practice Address - Zip Code:32446
Practice Address - Country:US
Practice Address - Phone:850-482-9222
Practice Address - Fax:850-718-0434
Is Sole Proprietor?:No
Enumeration Date:2006-12-12
Last Update Date:2013-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP1127912363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
P23667Medicare UPIN
FLY9418WMedicare ID - Type Unspecified