Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0011X | Interventional Cardiology | 209.005778 | IL |
Y | 363LA2200X | Nurse Practitioner - Adult Health | 209005778 | IL |
NPI | 1063457794 |
---|---|
Provider Name | Lori Beth Helmers |
First Address | O Fallon, IL 62269-1282 |
Second Address | O Fallon, IL 62269-1282 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/06/2006 |
Last Update Date | 21/12/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
749778 | HEALTHLINK (01) | |
P00320293 | RR MEDICARE (01) | |
Q70017 | (02) | IL |
Q70017 | MERCY (01) |