Provider Demographics
NPI:1073325254
Name:VANDIVER, HELENA MARGARET
Entity type:Individual
Prefix:
First Name:HELENA
Middle Name:MARGARET
Last Name:VANDIVER
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 1:241 POULI RD
Mailing Address - Street 2:
Mailing Address - City:KAILUA
Mailing Address - State:HI
Mailing Address - Zip Code:96734-3414
Mailing Address - Country:US
Mailing Address - Phone:262-344-1373
Mailing Address - Fax:
Practice Address - Street 1:241 POULI RD
Practice Address - Street 2:
Practice Address - City:KAILUA
Practice Address - State:HI
Practice Address - Zip Code:96734-3414
Practice Address - Country:US
Practice Address - Phone:262-344-1373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-01-23
Last Update Date:2025-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program