Provider Demographics
NPI:1821604018
Name:VANHELTEBRAKE, PATRICIA A (RN)
Entity Type:Individual
Prefix:
First Name:PATRICIA
Middle Name:A
Last Name:VANHELTEBRAKE
Suffix:
Gender:F
Credentials:RN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:333 WEST COLORADO AVE
Mailing Address - Street 2:PO BOX 949
Mailing Address - City:TELLURIDE
Mailing Address - State:CO
Mailing Address - Zip Code:81435
Mailing Address - Country:US
Mailing Address - Phone:970-728-4289
Mailing Address - Fax:970-728-9276
Practice Address - Street 1:333 WEST COLORADO AVE
Practice Address - Street 2:
Practice Address - City:TELLURIDE
Practice Address - State:CO
Practice Address - Zip Code:81435
Practice Address - Country:US
Practice Address - Phone:970-728-4289
Practice Address - Fax:970-728-9276
Is Sole Proprietor?:No
Enumeration Date:2020-09-22
Last Update Date:2020-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CORN.1666558163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse