1073697504 NPI number — HELEN WEEMS ARNP

Table of content: HELEN WEEMS ARNP (NPI 1073697504)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1073697504 NPI number — HELEN WEEMS ARNP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
WEEMS
Provider First Name:
HELEN
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
ARNP
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1073697504
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/28/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 4027
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
WHITEFISH
Provider Business Mailing Address State Name:
MT
Provider Business Mailing Address Postal Code:
59937
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
406-730-8682
Provider Business Mailing Address Fax Number:
406-730-8685

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
737 SPOKANE AVE.
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
WHITEFISH
Provider Business Practice Location Address State Name:
MT
Provider Business Practice Location Address Postal Code:
59937
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
206-601-2447
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/24/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 163W00000X , with the licence number:  RN00135708 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 163W00000X , with the licence number: NURRNLIC103041 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: AP30005514 , registered in the state of WA ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 363L00000X , with the licence number: NURAPRNLIC103291 , registered in the state of MT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 9625948 , issued by the state of ( WA ) . This identifiers is of the category "MEDICAID".




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