Individual
MS. NICOLE MARIE HELSOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
5750 FALLS DR, FORT WAYNE, IN 46804-7147
(260) 436-8000
(260) 432-5587
Mailing address
5750 FALLS DR, FORT WAYNE, IN 46804-7147
(260) 436-8000
(260) 432-5587
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10000849A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000386480
BCBS
—
01
—
P00311647
MEDICARE RAILROAD
—
Enumeration date
09/20/2006
Last updated
11/06/2007
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