Healthcare Provider Details

I. General information

NPI: 1235092198
Provider Name (Legal Business Name): ASHLEY ANNE HELGESON
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 12/08/2025
Last Update Date: 12/08/2025
Certification Date: 12/08/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13500 BRADLEY BLVD
BECKER MN
55308-9505
US

IV. Provider business mailing address

13500 BRADLEY BLVD
BECKER MN
55308-9505
US

V. Phone/Fax

Practice location:
  • Phone: 763-238-6976
  • Fax:
Mailing address:
  • Phone: 763-238-6976
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code311ZA0620X
TaxonomyAdult Care Home Facility
License Number1117990
License Number StateMN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: