Provider Demographics
NPI:1023408960
Name:FLUDD, HELEN D
Entity type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:D
Last Name:FLUDD
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 752
Mailing Address - Street 2:
Mailing Address - City:JACKSONVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28541-0752
Mailing Address - Country:US
Mailing Address - Phone:910-939-4663
Mailing Address - Fax:910-939-5079
Practice Address - Street 1:123 HENDERSON DR
Practice Address - Street 2:
Practice Address - City:JACKSONVILLE
Practice Address - State:NC
Practice Address - Zip Code:28540-5601
Practice Address - Country:US
Practice Address - Phone:910-939-4663
Practice Address - Fax:910-939-5079
Is Sole Proprietor?:Yes
Enumeration Date:2015-01-30
Last Update Date:2017-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes172V00000XOther Service ProvidersCommunity Health Worker
No251S00000XAgenciesCommunity/Behavioral Health
No253J00000XAgenciesFoster Care Agency
No251E00000XAgenciesHome Health
No251C00000XAgenciesDay Training, Developmentally Disabled Services
No251B00000XAgenciesCase Management