Healthcare Provider Details

I. General information

NPI: 1093959165
Provider Name (Legal Business Name): TAMIKA LASHUN HELTON ACNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/21/2009
Last Update Date: 05/20/2026
Certification Date: 05/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6600 VAN AALST BLVD BLDG 9250
FORT MOORE GA
31905-2102
US

IV. Provider business mailing address

6600 VAN AALST BLVD BLDG 9250
FORT BENNING GA
31905-2102
US

V. Phone/Fax

Practice location:
  • Phone: 706-544-8301
  • Fax:
Mailing address:
  • Phone: 706-544-8301
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberRN170748
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363LA2100X
TaxonomyAcute Care Nurse Practitioner
License NumberRN170748
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: