Individual ProviderRoseline MakindeNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address5808 State Bridge Rd, Johns Creek, GA 30097-6476(678) 495-0162(615) 425-4287PECOS EnrollmentBased on the most recent information from CMS, provider Roseline Makinde 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 today at 9:24 AM.Profile DetailsProvider ID1902108491Provider TypeIndividualFull NameMakinde, RoselineGenderFemaleSole ProprietorNoEnumeration Date12/3/2010Last Updated12/3/2010Contact InformationPractice LocationPractice Address5808 State Bridge Rd, Johns Creek, GA 30097-6476Phone(678) 495-0162FaxUnlisted FaxMailing LocationMailing Address8 Cadillac Dr, Suite 250, Brentwood, TN 37027-5087Phone(615) 425-4287FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseRN162552Georgia