Healthcare Provider Details

I. General information

NPI: 1508043704
Provider Name (Legal Business Name): PATRICIA ANNETTE HELTON LVN
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

819 WATER ST STE 300
KERRVILLE TX
78028-5330
US

IV. Provider business mailing address

107 INDUSTRIAL LOOP
FREDERICKSBURG TX
78624-5401
US

V. Phone/Fax

Practice location:
  • Phone: 830-258-5430
  • Fax: 830-792-5771
Mailing address:
  • Phone: 830-997-8696
  • Fax: 830-997-6311

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code164X00000X
TaxonomyLicensed Vocational Nurse
License Number155126
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: