Healthcare Provider Details

I. General information

NPI: 1932311206
Provider Name (Legal Business Name): HELENA IRENE STORMONT ARNP
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/07/2007
Last Update Date: 05/14/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1301 W 12TH AVE STE 105
EMPORIA KS
66801-2588
US

IV. Provider business mailing address

1201 W 12TH AVE
EMPORIA KS
66801-2504
US

V. Phone/Fax

Practice location:
  • Phone: 620-340-6181
  • Fax: 620-340-6182
Mailing address:
  • Phone: 620-343-6800
  • Fax: 620-341-5045

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number45733
License Number StateKS

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: