Kelly Eileen Privett | Blytheville, AR • PECOS Search

Kelly Eileen Privett

Case Manager/Care Coordinator

Other Service Providers

604 N Tennessee St, Blytheville, AR 72315-2157

PECOS Enrollment

Based on the most recent information from CMS, provider Kelly Eileen Privett 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
1720400872
Provider Type
Individual
Full Name
Privett, Kelly Eileen
Gender
Female

Sole Proprietor
No
Enumeration Date
1/8/2014
Last Updated
1/8/2014

Contact Information

Practice Location

604 N Tennessee St, Blytheville, AR 72315-2157

Unlisted Fax

Mailing Location

604 N Tennessee St, Blytheville, AR 72315-2157

Unlisted Fax

Provider Taxonomies

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