Provider Demographics
NPI:1902812365
Name:PAWLIK-HELGESON, DONNA T (PNP)
Entity Type:Individual
Prefix:
First Name:DONNA
Middle Name:T
Last Name:PAWLIK-HELGESON
Suffix:
Gender:F
Credentials:PNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:701 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:MINNEAPOLIS
Mailing Address - State:MN
Mailing Address - Zip Code:55415-1623
Mailing Address - Country:US
Mailing Address - Phone:612-873-6005
Mailing Address - Fax:612-630-8242
Practice Address - Street 1:701 PARK AVE
Practice Address - Street 2:
Practice Address - City:MINNEAPOLIS
Practice Address - State:MN
Practice Address - Zip Code:55415-1623
Practice Address - Country:US
Practice Address - Phone:612-873-2435
Practice Address - Fax:612-904-4277
Is Sole Proprietor?:No
Enumeration Date:2006-07-31
Last Update Date:2007-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN92116363LP0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0200XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPediatrics
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN12-12532OtherMEDICA
MN979825100Medicaid
MN9D453PAOtherBLUE CROSS BLUE SHIELD
MNP37434Medicare UPIN
MN500003849Medicare Oscar/Certification
MN979825100Medicaid