Individual
JACKIE MARIE HELMS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
5177 MCCARTY LN, LAFAYETTE, IN 47905-8764
(765) 838-6717
(765) 838-4334
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363L00000X
Nurse Practitioner
Primary
71015684A
IN
363LF0000X
Family Nurse Practitioner
209.015153
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1104578847
ANTHEM PTAN
IN
05
—
300097528
—
IN
Enumeration date
11/23/2016
Last updated
01/07/2025
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