Provider Demographics
NPI:1548487325
Name:GIFFORD, HELEN SUE (RPT)
Entity type:Individual
Prefix:MS
First Name:HELEN
Middle Name:SUE
Last Name:GIFFORD
Suffix:
Gender:F
Credentials:RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 VILLAGE CIRCLE DR
Mailing Address - Street 2:
Mailing Address - City:PLATTE CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64079-8211
Mailing Address - Country:US
Mailing Address - Phone:816-560-6577
Mailing Address - Fax:
Practice Address - Street 1:7850 FREEMAN AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:KS
Practice Address - Zip Code:66112-2133
Practice Address - Country:US
Practice Address - Phone:913-334-3666
Practice Address - Fax:913-299-1495
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS11-00370314000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes314000000XNursing & Custodial Care FacilitiesSkilled Nursing Facility