=====================================================
General NPI Number Information
=====================================================
NPI Number | 1487649786
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | PAMELA B HELMS FNP
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 09/13/2005
-----------------------------------------------------
Last Update Date | 06/15/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 11766 HIGHWAY 27
-----------------------------------------------------
City | SUMMERVILLE
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30747-5989
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-857-3915
-----------------------------------------------------
Fax | 706-857-5638
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 420 E 2ND AVE STE 103
-----------------------------------------------------
City | ROME
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30161-3210
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 706-509-3000
-----------------------------------------------------
Fax | 706-509-4608
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 363LF0000X
-----------------------------------------------------
Taxonomy Name | Family Nurse Practitioner
-----------------------------------------------------
License Number | RN081220
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------