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Lul Kassim

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

10925 State Road 54, New Port Richey, FL 34655-2277

PECOS Enrollment

Based on the most recent information from CMS, provider Lul Kassim 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 9:24 AM.

Profile Details

Provider ID
1194111450
Provider Type
Individual
Full Name
Kassim, Lul
Credential
FNP

Gender
Female
Sole Proprietor
No
Enumeration Date
4/13/2015
Last Updated
10/25/2022

Contact Information

Practice Location

10925 State Road 54, New Port Richey, FL 34655-2277

(727) 577-6888

Unlisted Fax

Mailing Location

10925 State Road 54, New Port Richey, FL 34655-2277

(727) 577-6888

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP9402908 Florida

Lul Kassim

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Ulseth, Jennifer

Topp, Lauren M

Haimes, Gabriella Judith

Zagorodny, Alisa

Rowe, Andrea D

Stewart, Rachel

Christmann, Bianca

Gunderson, Alana

Jaime, Nereida

Wallace, Lakenya Chimere