Individual ProviderNichelle D MossCase Manager/Care CoordinatorOther Service ProvidersPractice Address634 W Main St, Blytheville, AR 72315-3336(870) 780-6986PECOS EnrollmentBased on the most recent information from CMS, provider Nichelle D Moss does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 3 days ago.Profile DetailsProvider ID1356776330Provider TypeIndividualFull NameMoss, Nichelle DCredentialMHPPGenderFemaleSole ProprietorNoEnumeration Date9/9/2013Last Updated9/9/2013Contact InformationPractice LocationPractice Address634 W Main St, Blytheville, AR 72315-3336Phone(870) 780-6986Fax(870) 780-6987Mailing LocationMailing Address634 W Main St, Blytheville, AR 72315-3336Phone(870) 780-6986Fax(870) 780-6987Provider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer