Provider Demographics
NPI:1982957999
Name:HELMS, JESSE
Entity type:Individual
Prefix:
First Name:JESSE
Middle Name:
Last Name:HELMS
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8509 STATE LINE RD
Mailing Address - Street 2:1436
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64114-2723
Mailing Address - Country:US
Mailing Address - Phone:816-444-0019
Mailing Address - Fax:
Practice Address - Street 1:8509 STATE LINE RD
Practice Address - Street 2:1436
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64114-2723
Practice Address - Country:US
Practice Address - Phone:816-444-0019
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-10-16
Last Update Date:2012-10-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2012027066183500000X
KS1-15150183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist