Provider Demographics
NPI:1649305764
Name:JOSEY, HELEN (NP)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:JOSEY
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 E MAIN ST
Mailing Address - Street 2:SUITE C
Mailing Address - City:MEDFORD
Mailing Address - State:OR
Mailing Address - Zip Code:97501-6041
Mailing Address - Country:US
Mailing Address - Phone:541-789-5526
Mailing Address - Fax:541-789-5203
Practice Address - Street 1:781 BLACK OAK DR
Practice Address - Street 2:SUITE 102
Practice Address - City:MEDFORD
Practice Address - State:OR
Practice Address - Zip Code:97504-9502
Practice Address - Country:US
Practice Address - Phone:541-789-4236
Practice Address - Fax:541-789-5965
Is Sole Proprietor?:No
Enumeration Date:2007-02-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR000024166N3363LX0106X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LX0106XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerOccupational Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR018130Medicaid
OR018130Medicaid