Provider Demographics
NPI:1821154600
Name:NILSEN, HELENE S (APRN)
Entity Type:Individual
Prefix:
First Name:HELENE
Middle Name:S
Last Name:NILSEN
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1728 LAPORTE RD
Mailing Address - Street 2:
Mailing Address - City:MORRISVILLE
Mailing Address - State:VT
Mailing Address - Zip Code:05661-8316
Mailing Address - Country:US
Mailing Address - Phone:802-888-5891
Mailing Address - Fax:
Practice Address - Street 1:111 MAIN ST
Practice Address - Street 2:
Practice Address - City:HYDE PARK
Practice Address - State:VT
Practice Address - Zip Code:05655
Practice Address - Country:US
Practice Address - Phone:802-888-6215
Practice Address - Fax:802-888-9474
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VT1010010221163WP0807X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1005442Medicaid