Individual ProviderJennifer ThornNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address4257 Bastogne St Building 5, Fort Bragg, NC 28310-4963(910) 907-9647(256) 463-5469PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Thorn 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 9:43 AM.Profile DetailsProvider ID1366010902Provider TypeIndividualFull NameThorn, JenniferCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date6/10/2021Last Updated4/10/2023Contact InformationPractice LocationPractice Address4257 Bastogne St Building 5, Fort Bragg, NC 28310-4963Phone(910) 907-9647FaxUnlisted FaxMailing LocationMailing Address6257 Lake Trail Dr, Fayetteville, NC 28304-0551Phone(256) 463-5469FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense5014499North Carolina