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Jessica Leigh Cantrell

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2150 Pennsylvania Ave NW, Washington, DC 20037-3201

PECOS Enrollment

This provider is enrolled in PECOS as JESSICA CANTRELL.

Based on the most recent information from CMS, provider Jessica Leigh Cantrell is legally eligible to order and refer claims for DME and PMD services only.

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

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1285246074
Provider Type
Individual
Full Name
Cantrell, Jessica Leigh
Credential
CRNP

Gender
Female
Sole Proprietor
No
Enumeration Date
8/21/2020
Last Updated
12/6/2022

Contact Information

Practice Location

2150 Pennsylvania Ave NW, Washington, DC 20037-3201

(202) 741-2234

Unlisted Fax

Mailing Location

2150 Pennsylvania Ave NW, Washington, DC 20037-3201

(202) 741-2234

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License NP200003503 District of Columbia
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License RN200003503 District of Columbia
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License 244176 South Carolina
Code 163W00000X	Description Registered Nurse Nursing Service Providers	License 1-167486 Alabama

Jessica Leigh Cantrell

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

Code

Description

License

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Lim, Sue

Gorantla, Surekha