Provider Demographics
NPI:1861472730
Name:VAN DOLSEN, HELGA (CRNP)
Entity Type:Individual
Prefix:MRS
First Name:HELGA
Middle Name:
Last Name:VAN DOLSEN
Suffix:
Gender:F
Credentials:CRNP
Other - Prefix:MS
Other - First Name:HELGA
Other - Middle Name:
Other - Last Name:WOODALL
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:CRNP
Mailing Address - Street 1:1111 BENFIELD BLVD
Mailing Address - Street 2:SUITE 200
Mailing Address - City:MILLERSVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:21108-3002
Mailing Address - Country:US
Mailing Address - Phone:410-729-5100
Mailing Address - Fax:410-729-5156
Practice Address - Street 1:4201 MITCHELLVILLE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:BOWIE
Practice Address - State:MD
Practice Address - Zip Code:20716-3163
Practice Address - Country:US
Practice Address - Phone:301-262-5900
Practice Address - Fax:410-741-0865
Is Sole Proprietor?:No
Enumeration Date:2006-01-18
Last Update Date:2011-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDR061673363LA2200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LA2200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerAdult Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD1995596OtherAETNA HMO
MD234261800Medicaid
MD648934-01OtherCAREFIRST MD RENDERING
MDP00401331OtherRAILROAD MEDICARE
MD203807OtherJHHC PROVIDER NUMBER
MD7270032OtherAETNA PPO
MD7605-0079OtherCAREFIRST BLUECHOICE
MDP00401331OtherRAILROAD MEDICARE
MDS63685Medicare UPIN