Deshona Nicole Moss | Blytheville, AR • PECOS Search

Deshona Nicole Moss

Case Manager/Care Coordinator

Other Service Providers

1510 Byrum Rd, Blytheville, AR 72315-8033

PECOS Enrollment

Based on the most recent information from CMS, provider Deshona Nicole Moss does not have current enrollment records in PECOS.

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

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1518259019
Provider Type
Individual
Full Name
Moss, Deshona Nicole
Gender
Female

Sole Proprietor
Yes
Enumeration Date
5/3/2011
Last Updated
5/3/2011

Contact Information

Practice Location

1510 Byrum Rd, Blytheville, AR 72315-8033

Unlisted Fax

Mailing Location

1510 Byrum Rd, Blytheville, AR 72315-8033

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 171M00000X Primary	Description Case Manager/Care Coordinator Other Service Providers	License Unlisted Issuer