Individual ProviderJennifer UlsethNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2433 Country Place Blvd Bldg B, Trinity, FL 34655-1163(813) 844-8200PECOS EnrollmentBased on the most recent information from CMS, provider Jennifer Ulseth 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 9:24 AM.Profile DetailsProvider ID1851865976Provider TypeIndividualFull NameUlseth, JenniferCredentialAPRNGenderFemaleSole ProprietorNoEnumeration Date1/12/2019Last Updated10/10/2022Contact InformationPractice LocationPractice Address2433 Country Place Blvd Bldg B, Trinity, FL 34655-1163Phone(813) 844-8200FaxUnlisted FaxMailing LocationMailing AddressPO Box 1289, Tampa, FL 33601-1289Phone(813) 844-8200FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAPRN11000477FloridaProvider IdentifiersIDDescriptionIssuerID1041664000DescriptionMedicaidIssuerUnlistedFloridaID104166400DescriptionMedicaidIssuerUnlistedFlorida