MEDICARE: ELIZABETH LOUISE HELMS FNP

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	363L00000X	Nurse Practitioner	71000222A	IN
2	363LF0000X	Family Nurse Practitioner	71000222A	IN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	500016809	OTHER	IN	RAILROAD
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4	000000297145	OTHER	IL	BC/BS #

General Provider Information

NPI Number	:	1104827096
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ELIZABETH LOUISE HELMS FNP

Provider Business Mailing Address
First Line	:	330 W DEERFIELD RD
Second Line	:
City	:	UNION CITY
State	:	IN
Zip	:	47390-1039
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	330 W DEERFIELD RD
Second Line	:
City	:	UNION CITY
State	:	IN
Zip	:	47390-1039
Country	:	US
Telephone Number	:	765-964-6200
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/02/2005
Last Update Date	:	06/28/2022

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