Provider Demographics
NPI:1053336990
Name:HELLESTO, LEE ANNE (ANP)
Entity type:Individual
Prefix:
First Name:LEE ANNE
Middle Name:
Last Name:HELLESTO
Suffix:
Gender:F
Credentials:ANP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:19686 HOLLYGRAPE ST
Mailing Address - Street 2:
Mailing Address - City:BEND
Mailing Address - State:OR
Mailing Address - Zip Code:97702-2688
Mailing Address - Country:US
Mailing Address - Phone:541-241-6181
Mailing Address - Fax:
Practice Address - Street 1:888 NW HILL ST STE 3
Practice Address - Street 2:
Practice Address - City:BEND
Practice Address - State:OR
Practice Address - Zip Code:97703-2942
Practice Address - Country:US
Practice Address - Phone:541-241-6181
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2015-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK884363LF0000X
OR201350015NP363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily