Healthcare Provider Details

I. General information

NPI: 1497942650
Provider Name (Legal Business Name): SUSAN CAROL HELLING RN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/01/2007
Last Update Date: 10/01/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1811 MAPLEWOOD LN
ABERDEEN SD
57401-8900
US

IV. Provider business mailing address

1811 MAPLEWOOD LN
ABERDEEN SD
57401-8900
US

V. Phone/Fax

Practice location:
  • Phone: 605-225-8725
  • Fax:
Mailing address:
  • Phone: 605-225-8725
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code163WC0400X
TaxonomyCase Management Registered Nurse
License NumberR017972
License Number StateSD
# 2
Primary TaxonomyN
Taxonomy Code364SC2300X
TaxonomyChronic Care Clinical Nurse Specialist
License NumberCS004114
License Number StateSD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: