Provider Demographics
NPI:1255648119
Name:HELMERS, MARY JANE
Entity type:Individual
Prefix:MS
First Name:MARY
Middle Name:JANE
Last Name:HELMERS
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 1:421 BRYDON RD
Mailing Address - Street 2:
Mailing Address - City:DAYTON
Mailing Address - State:OH
Mailing Address - Zip Code:45419-1822
Mailing Address - Country:US
Mailing Address - Phone:937-299-0421
Mailing Address - Fax:
Practice Address - Street 1:421 BRYDON RD
Practice Address - Street 2:
Practice Address - City:DAYTON
Practice Address - State:OH
Practice Address - Zip Code:45419-1822
Practice Address - Country:US
Practice Address - Phone:937-299-0421
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2010-09-13
Last Update Date:2010-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH140438163W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes163W00000XNursing Service ProvidersRegistered Nurse