Provider Demographics
NPI:1023426731
Name:HELMICK, MARTIE
Entity type:Individual
Prefix:
First Name:MARTIE
Middle Name:
Last Name:HELMICK
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 944
Mailing Address - Street 2:
Mailing Address - City:KEYSER
Mailing Address - State:WV
Mailing Address - Zip Code:26726-0944
Mailing Address - Country:US
Mailing Address - Phone:304-788-6462
Mailing Address - Fax:304-788-6555
Practice Address - Street 1:514 NEW CREEK HWY STE 1
Practice Address - Street 2:
Practice Address - City:KEYSER
Practice Address - State:WV
Practice Address - Zip Code:26726-9526
Practice Address - Country:US
Practice Address - Phone:304-788-6462
Practice Address - Fax:304-788-6555
Is Sole Proprietor?:No
Enumeration Date:2014-07-25
Last Update Date:2022-04-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV82384363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily