Healthcare Provider Details

I. General information

NPI: 1144293010
Provider Name (Legal Business Name): ELIZABETH J HELMS MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/09/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1010 THREE SPRINGS BLVD STE 255
DURANGO CO
81301-8296
US

IV. Provider business mailing address

1010 THREE SPRINGS BLVD
DURANGO CO
81301-8296
US

V. Phone/Fax

Practice location:
  • Phone: 970-764-3825
  • Fax: 970-764-3839
Mailing address:
  • Phone: 970-247-4311
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License NumberDR-43842
License Number StateCO

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

# 1
Identifier78073545
Identifier TypeMEDICAID
Identifier StateCO
Identifier Issuer

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: