Provider Demographics
NPI:1780328401
Name:HELTON, KATHERINE MAE (MSN, FNP)
Entity type:Individual
Prefix:
First Name:KATHERINE
Middle Name:MAE
Last Name:HELTON
Suffix:
Gender:F
Credentials:MSN, FNP
Other - Prefix:
Other - First Name:KATHERINE
Other - Middle Name:
Other - Last Name:CLEVELAND
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:54 HOSPITAL DR
Mailing Address - Street 2:
Mailing Address - City:OSAGE BEACH
Mailing Address - State:MO
Mailing Address - Zip Code:65065-3050
Mailing Address - Country:US
Mailing Address - Phone:573-348-8000
Mailing Address - Fax:573-348-8309
Practice Address - Street 1:54 HOSPITAL DR STE 201
Practice Address - Street 2:
Practice Address - City:OSAGE BEACH
Practice Address - State:MO
Practice Address - Zip Code:65065-3050
Practice Address - Country:US
Practice Address - Phone:573-302-2764
Practice Address - Fax:573-302-2767
Is Sole Proprietor?:No
Enumeration Date:2022-04-27
Last Update Date:2022-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2018026915363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily