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Kimberly Lovell Spiller

Case Manager/Care Coordinator

Other Service Providers

1510 Byrum Rd, Blytheville, AR 72315-8033

PECOS Enrollment

Based on the most recent information from CMS, provider Kimberly Lovell Spiller does not have current enrollment records in PECOS.

Part B
Medicare Part B
Not Enrolled
HHA
Home Health Agency
Not Enrolled
DME
Durable Medical Equipment
Not Enrolled
PMD
Power Mobility Device
Not Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1255569760
Provider Type
Individual
Full Name
Spiller, Kimberly Lovell
Title
Miss

Gender
Female
Sole Proprietor
Yes
Enumeration Date
6/24/2009
Last Updated
6/24/2009

Contact Information

Practice Location

1510 Byrum Rd, Blytheville, AR 72315-8033

(870) 532-2600

Unlisted Fax

Mailing Location

1212 S Lilly St, Blytheville, AR 72315-5310

(870) 763-9226

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer

Provider Identifiers

ID	Description	Issuer
ID 161010724	Description Medicaid	Issuer Unlisted Arkansas

Kimberly Lovell Spiller

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

Welch, Sarah Lynn

Clark, Meshia

Jackson, Bradley

Mckinnie, Jessica

Townsend, Kristen

Black, Tiara M

Benson, Jacquis

Mcray, Markeeta Lashawn

Hodges, Cryshana

Hall, Danielle