Provider Demographics
NPI:1700154929
Name:HELGESEN, LORI ELLEN (APRN)
Entity Type:Individual
Prefix:
First Name:LORI
Middle Name:ELLEN
Last Name:HELGESEN
Suffix:
Gender:F
Credentials:APRN
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 449
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:OH
Mailing Address - Zip Code:45750-0449
Mailing Address - Country:US
Mailing Address - Phone:740-374-4500
Mailing Address - Fax:740-374-5887
Practice Address - Street 1:40 WHITE OAK PROFESSIONAL CTR
Practice Address - Street 2:
Practice Address - City:VINCENT
Practice Address - State:OH
Practice Address - Zip Code:45784-9117
Practice Address - Country:US
Practice Address - Phone:740-678-2374
Practice Address - Fax:740-678-8139
Is Sole Proprietor?:Yes
Enumeration Date:2011-12-02
Last Update Date:2020-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT04902363L00000X
OH14098-NP363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0083342Medicaid
WV3910000633Medicaid
OH0083342Medicaid
OHH195711Medicare PIN
OHH195710Medicare PIN