Healthcare Provider Details

I. General information

NPI: 1922596329
Provider Name (Legal Business Name): AUDRA LEE HELFERT RN,
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2018
Last Update Date: 05/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

200 N MAIN ST
EVANSVILLE IN
47711-5451
US

IV. Provider business mailing address

7488 TAYLORVILLE RD
TENNYSON IN
47637-9223
US

V. Phone/Fax

Practice location:
  • Phone: 812-491-4296
  • Fax:
Mailing address:
  • Phone: 812-774-8088
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License Number28142225A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: