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Jessica Ellis Fralick

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

PECOS Enrollment

This provider is enrolled in PECOS as JESSICA FRALICK.

Based on the most recent information from CMS, provider Jessica Ellis Fralick is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records yesterday at 12:14 PM.

Profile Details

Provider ID
1962819565
Provider Type
Individual
Full Name
Fralick, Jessica Ellis
Credential
DNP, FNP-C

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/15/2014
Last Updated
11/15/2018

Contact Information

Practice Location

370 S Pike W, Sumter, SC 29150-2664

(803) 774-7337

(803) 774-4629

Mailing Location

370 S Pike W, Sumter, SC 29150-2664

(803) 774-7337

(803) 774-4629

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 18948 South Carolina

Jessica Ellis Fralick

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

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