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NPI Code Detail

MEDICARE: HELEN JAKSTAS RN,MHP,MS

MEDICARE:   HELEN  JAKSTAS  RN,MHP,MS
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
1363LF0000XFamily Nurse Practitioner4704146563MI

General Provider Information

NPI Number : 1326148479
Entity Type Code : Individual
Provider Name (Legal Business Name) : HELEN JAKSTAS RN,MHP,MS
Provider Business Mailing Address
First Line : 770 RIVERSIDE AVE
Second Line : SUITE 17
City : ADRIAN
State : MI
Zip : 49221-1476
Country : US
Telephone Number : 517-265-8134
Fax Number : 517-265-2249
Provider Business Practice Location Address
First Line : 770 RIVERSIDE AVE
Second Line : SUITE 17
City : ADRIAN
State : MI
Zip : 49221-1476
Country : US
Telephone Number : 517-265-8134
Fax Number : 517-265-2249
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/25/2006
Last Update Date : 07/29/2015

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Directions to “ HELEN JAKSTAS RN,MHP,MS” Practice Location

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