Provider Demographics
NPI:1942832647
Name:HELMUS, JENNA (RN, BSN, CCRN, SRNA)
Entity Type:Individual
Prefix:
First Name:JENNA
Middle Name:
Last Name:HELMUS
Suffix:
Gender:F
Credentials:RN, BSN, CCRN, SRNA
Other - Prefix:
Other - First Name:JENNA
Other - Middle Name:
Other - Last Name:DURALDE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17652 CINDY LN
Mailing Address - Street 2:
Mailing Address - City:GRASS VALLEY
Mailing Address - State:CA
Mailing Address - Zip Code:95945-9671
Mailing Address - Country:US
Mailing Address - Phone:530-680-9001
Mailing Address - Fax:
Practice Address - Street 1:101 W 8TH AVE
Practice Address - Street 2:
Practice Address - City:SPOKANE
Practice Address - State:WA
Practice Address - Zip Code:99204-2307
Practice Address - Country:US
Practice Address - Phone:509-474-4971
Practice Address - Fax:509-474-5343
Is Sole Proprietor?:No
Enumeration Date:2020-02-10
Last Update Date:2023-09-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
CA95002084367500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes367500000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Anesthetist, Certified Registered
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program