Basic Information
Provider Information | |||||||||
NPI: | 1871547059 | ||||||||
EntityType: | 1 | ||||||||
ReplacementNPI: |   | ||||||||
OrganizationName: |   | ||||||||
LastName: | HELBLING | ||||||||
FirstName: | TERRI | ||||||||
MiddleName: | S | ||||||||
NamePrefix: |   | ||||||||
NameSuffix: |   | ||||||||
Credential: | NP | ||||||||
OtherOrganizationName: |   | ||||||||
OtherOrganizationType: |   | ||||||||
OtherLastName: | KAYNE | ||||||||
OtherFirstName: | TERRI | ||||||||
OtherMiddleName: | S | ||||||||
OtherNamePrefix: |   | ||||||||
OtherNameSuffix: |   | ||||||||
OtherCredential: | NP | ||||||||
OtherLastNameType: | 1 | ||||||||
Mailing Information | |||||||||
Address1: | 75-5751 KUAKINI HWY STE 203 | ||||||||
Address2: |   | ||||||||
City: | KAILUA KONA | ||||||||
State: | HI | ||||||||
PostalCode: | 967401753 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 8083333600 | ||||||||
FaxNumber: | 8089615167 | ||||||||
Practice Location | |||||||||
Address1: | 15-2866 PAHOA VILLAGE RD BLDG C | ||||||||
Address2: |   | ||||||||
City: | PAHOA | ||||||||
State: | HI | ||||||||
PostalCode: | 967787720 | ||||||||
CountryCode: | US | ||||||||
TelephoneNumber: | 0833336008 | ||||||||
FaxNumber: |   | ||||||||
Other Information | |||||||||
ProviderEnumerationDate: | 05/20/2006 | ||||||||
LastUpdateDate: | 07/19/2022 | ||||||||
NPIDeactivationReasonCode: |   | ||||||||
NPIDeactivationDate: |   | ||||||||
NPIReactivationDate: |   | ||||||||
ProviderGenderCode: | F | ||||||||
AuthorizedOfficialLastName: |   | ||||||||
AuthorizedOfficialFirstName: |   | ||||||||
AuthorizedOfficialMiddleName: |   | ||||||||
AuthorizedOfficialTitleorPosition: |   | ||||||||
AuthorizedOfficialTelephone: |   | ||||||||
IsSoleProprietor: | N | ||||||||
IsOrganizationSubpart: |   | ||||||||
ParentOrganizationLBN: |   | ||||||||
AuthorizedOfficialNamePrefix: |   | ||||||||
AuthorizedOfficialNameSuffix: |   | ||||||||
AuthorizedOfficialCredential: |   | ||||||||
NPICertificationDate: | 07/19/2022 |
Taxonomy Information
Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 363LF0000X | 71001440A | IN | N |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family | 2084P0800X | 71001440A | IN | N |   | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | Psychiatry | 363LF0000X | 1937 | HI | Y |   | Physician Assistants & Advanced Practice Nursing Providers | Nurse Practitioner | Family |
ID Information
ID | Type | State | Issuer | Description | 200813380 | 05 | IN |   | MEDICAID |