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Kelle Christine Degroat

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

1818 Short Branch Dr Ste 102, Trinity, FL 34655-4425

PECOS Enrollment

This provider is enrolled in PECOS as KELLE DEGROAT.

Based on the most recent information from CMS, provider Kelle Christine Degroat is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 9:24 AM.

Profile Details

Provider ID
1487122297
Provider Type
Individual
Full Name
Degroat, Kelle Christine
Credential
APRN

Gender
Female
Sole Proprietor
Yes
Enumeration Date
11/9/2018
Last Updated
7/10/2024

Contact Information

Practice Location

1818 Short Branch Dr Ste 102, Trinity, FL 34655-4425

(727) 372-4500

Unlisted Fax

Mailing Location

7210 Red Oak Loop, New Port Richey, FL 34654-5714

(727) 364-1725

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License APRN11000089 Florida

Kelle Christine Degroat

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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