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Makayla Jean Green

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1649 Highway 192 W, London, KY 40741-1674

PECOS Enrollment

This provider is enrolled in PECOS as MAKAYLA GREEN.

Based on the most recent information from CMS, provider Makayla Jean Green is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 11:47 AM.

Profile Details

Provider ID
1154952844
Provider Type
Individual
Full Name
Green, Makayla Jean
Credential
APRN, FNP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
1/31/2020
Last Updated
1/29/2024

Contact Information

Practice Location

1649 Highway 192 W, London, KY 40741-1674

(606) 330-0055

Unlisted Fax

Mailing Location

PO Box 735, Flat Lick, KY 40935-0735

(606) 302-3525

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363L00000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 3014245 Kentucky
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 3014245 Kentucky

Makayla Jean Green

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Albertson, Daniel C

Jones, Anna Michelle

Graves, Taylor

Sjl Physician Management Services, Inc.

Fuse Medical

Spray, Trisha A

Pezzi, Melinda Mae

Fields, Tommie Lee

Collins, Stephanie Ann

Physician Express Care Billing