Individual ProviderLeeann WisnowskiNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1807 Short Branch Dr Ste 102, Trinity, FL 34655-4424(727) 376-3547PECOS EnrollmentBased on the most recent information from CMS, provider Leeann Wisnowski does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records yesterday at 9:24 AM.Profile DetailsProvider ID1932533221Provider TypeIndividualFull NameWisnowski, LeeannCredentialARNPGenderFemaleSole ProprietorNoEnumeration Date8/22/2013Last Updated1/13/2014Contact InformationPractice LocationPractice Address1807 Short Branch Dr Ste 102, Trinity, FL 34655-4424Phone(727) 376-3547FaxUnlisted FaxMailing LocationMailing Address1807 Short Branch Dr Ste 102, Trinity, FL 34655-4424Phone(727) 376-3547FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense9174576Florida