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Jerry Boyd Stover

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2817 Reilly St, Fort Bragg, NC 28310-7324

PECOS Enrollment

This provider is enrolled in PECOS as JERRY STOVER.

Based on the most recent information from CMS, provider Jerry Boyd Stover 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 today at 9:43 AM.

Profile Details

Provider ID
1194067306
Provider Type
Individual
Full Name
Stover, Jerry Boyd
Credential
FNP

Gender
Male
Sole Proprietor
Yes
Enumeration Date
3/26/2013
Last Updated
3/26/2013

Contact Information

Practice Location

2817 Reilly St, Fort Bragg, NC 28310-7324

(910) 907-6888

Unlisted Fax

Mailing Location

47 Laurel Dr, Spring Lake, NC 28390-7375

(910) 644-6554

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 156164 North Carolina

Jerry Boyd Stover

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Richard, Jason

Roumell, Nikolas John

Hilfiker, Rebecca Lynn

Szafrajda, Karen L

Hunt, Telina

Hilburn, Miranda Ammons

Day, Warren Thomas

Housel, Laurie Ann

Chapman, Ian Kendall

Smith, Nicole Leigh