1194816413 NPI number — DR. JOSEPHINE ZELMA HELMBRECHT AUD

Table of content: DR. JOSEPHINE ZELMA HELMBRECHT AUD (NPI 1194816413)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194816413 NPI number — DR. JOSEPHINE ZELMA HELMBRECHT AUD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HELMBRECHT
Provider First Name:
JOSEPHINE
Provider Middle Name:
ZELMA
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
AUD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
OLSON
Provider Other First Name:
JOSEPHINE
Provider Other Middle Name:
ZELMA
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1194816413
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/13/2016
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
110 1ST AVENUE EAST, SUITE 2
Provider Second Line Business Mailing Address:
P.O. BOX 589
Provider Business Mailing Address City Name:
CAMBRIDGE
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55008
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
763-742-4844
Provider Business Mailing Address Fax Number:
763-689-5939

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
237 SW 2ND AVE
Provider Second Line Business Practice Location Address:
STE 230
Provider Business Practice Location Address City Name:
CAMBRIDGE
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55008-1500
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
763-742-4844
Provider Business Practice Location Address Fax Number:
763-689-5939
Provider Enumeration Date:
09/28/2006

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: 231H00000X , with the licence number:  6425 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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