Provider Demographics
NPI:1194910505
Name:HELGESON, LINDA MT (NP)
Entity type:Individual
Prefix:
First Name:LINDA
Middle Name:MT
Last Name:HELGESON
Suffix:
Gender:F
Credentials:NP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3807 GREENLEAF AVE NW
Mailing Address - Street 2:
Mailing Address - City:BEMIDJI
Mailing Address - State:MN
Mailing Address - Zip Code:56601-5817
Mailing Address - Country:US
Mailing Address - Phone:218-751-9746
Mailing Address - Fax:218-759-0620
Practice Address - Street 1:3807 GREENLEAF AVE NW
Practice Address - Street 2:
Practice Address - City:BEMIDJI
Practice Address - State:MN
Practice Address - Zip Code:56601-5817
Practice Address - Country:US
Practice Address - Phone:218-751-9746
Practice Address - Fax:218-759-0620
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2008-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MNR0997553363L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363L00000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse Practitioner
Provider Identifiers
StateIdentifier IDID TypeIssuer
HP83855OtherHEALTHPARTNERS
0127904OtherMEDICA
1052867OtherPREFERREDONE
MN118430200Medicaid
MN1194910505Medicaid
HP83855OtherHEALTHPARTNERS