Provider Demographics
NPI:1558834853
Name:DUDLEY BURRELL, HELEN BALMACEDA (NURSE PRACTITIONER)
Entity type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:BALMACEDA
Last Name:DUDLEY BURRELL
Suffix:
Gender:
Credentials:NURSE PRACTITIONER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:49 W MERCURY BLVD
Mailing Address - Street 2:
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23669-2508
Mailing Address - Country:US
Mailing Address - Phone:757-269-9980
Mailing Address - Fax:757-330-0770
Practice Address - Street 1:49 W MERCURY BLVD
Practice Address - Street 2:
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23669-2508
Practice Address - Country:US
Practice Address - Phone:757-269-9980
Practice Address - Fax:757-330-0770
Is Sole Proprietor?:No
Enumeration Date:2019-01-09
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0001224788163WC0400X
VA0024177010363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
No163WC0400XNursing Service ProvidersRegistered NurseCase Management
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0017145636OtherLICENSE TO PRESCRIBE
VA0024177010OtherNURSE PRACTITIONER