Provider Demographics
NPI:1447226857
Name:LINK, HELEN R (APNP)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:R
Last Name:LINK
Suffix:
Gender:F
Credentials:APNP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5320 COACH LITE TRL
Mailing Address - Street 2:
Mailing Address - City:LOVES PARK
Mailing Address - State:IL
Mailing Address - Zip Code:61111-3515
Mailing Address - Country:US
Mailing Address - Phone:815-988-0779
Mailing Address - Fax:
Practice Address - Street 1:4320 SPRING CREEK RD STE 13
Practice Address - Street 2:
Practice Address - City:ROCKFORD
Practice Address - State:IL
Practice Address - Zip Code:61107-1157
Practice Address - Country:US
Practice Address - Phone:815-988-0779
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-24
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI441-033363LP0808X
IL277000032363LP0808X
WI98740-030163WP0807X, 163WP0809X
WI441-33363LP0808X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LP0808XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerPsychiatric/Mental Health
No163WP0807XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Child & Adolescent
No163WP0809XNursing Service ProvidersRegistered NursePsychiatric/Mental Health, Adult
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39405900Medicaid
WI39405900Medicaid