Individual ProviderMichaelyn ParkerNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address4457 Bayou Blvd, Pensacola, FL 32503-2601(850) 226-6801PECOS EnrollmentBased on the most recent information from CMS, provider Michaelyn Parker is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records yesterday at 11:57 AM.Profile DetailsProvider ID1255807418Provider TypeIndividualFull NameParker, MichaelynGenderFemaleSole ProprietorNoEnumeration Date10/15/2018Last Updated3/27/2019Contact InformationPractice LocationPractice Address4457 Bayou Blvd, Pensacola, FL 32503-2601Phone(850) 226-6801FaxUnlisted FaxMailing LocationMailing Address4457 Bayou Blvd, Pensacola, FL 32503-2601Phone(850) 226-6801FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense1-097606AlabamaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11000999FloridaProvider IdentifiersIDDescriptionIssuerID1255807418DescriptionOtherIssuerNPIID1-097606DescriptionOtherIssuerABNAlabama