Healthcare Provider Details

I. General information

NPI: 1982004453
Provider Name (Legal Business Name): HELEN PERRY RN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: HELEN SNEAD RN

II. Dates (important events)

Enumeration Date: 09/03/2014
Last Update Date: 11/12/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3627 UNIVERSITY BLVD S STE 700
JACKSONVILLE FL
32216-7403
US

IV. Provider business mailing address

3627 UNIVERSITY BLVD S STE 700
JACKSONVILLE FL
32216-7403
US

V. Phone/Fax

Practice location:
  • Phone: 904-399-5678
  • Fax:
Mailing address:
  • Phone: 904-399-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code163WC0200X
TaxonomyCritical Care Medicine Registered Nurse
License NumberRO88693
License Number StateAR
# 2
Primary TaxonomyN
Taxonomy Code163WE0003X
TaxonomyEmergency Registered Nurse
License NumberRO88693
License Number StateAR
# 3
Primary TaxonomyN
Taxonomy Code163WM0705X
TaxonomyMedical-Surgical Registered Nurse
License NumberR088693
License Number StateAR
# 4
Primary TaxonomyY
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License Number9425525
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: