Provider Demographics
NPI:1376936559
Name:HELM, TYRA ANNE
Entity type:Individual
Prefix:
First Name:TYRA
Middle Name:ANNE
Last Name:HELM
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TYRA
Other - Middle Name:ANNE
Other - Last Name:ZEMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:808 W 19TH AVE
Mailing Address - Street 2:
Mailing Address - City:ANCHORAGE
Mailing Address - State:AK
Mailing Address - Zip Code:99503-1703
Mailing Address - Country:US
Mailing Address - Phone:808-227-4709
Mailing Address - Fax:
Practice Address - Street 1:808 W 19TH AVE
Practice Address - Street 2:
Practice Address - City:ANCHORAGE
Practice Address - State:AK
Practice Address - Zip Code:99503-1703
Practice Address - Country:US
Practice Address - Phone:808-227-4709
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-03-11
Last Update Date:2015-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK7171164W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes164W00000XNursing Service ProvidersLicensed Practical Nurse