Individual ProviderMikell BozemanCase Manager/Care CoordinatorOther Service ProvidersPractice Address2041 Mlk Jr Ave SE, Washington, DC 20020(202) 717-9238PECOS EnrollmentBased on the most recent information from CMS, provider Mikell Bozeman 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 10:04 AM.Profile DetailsProvider ID1972386688Provider TypeIndividualFull NameBozeman, MikellGenderFemaleSole ProprietorYesEnumeration Date8/16/2023Last Updated8/16/2023Contact InformationPractice LocationPractice Address2041 Mlk Jr Ave SE, Washington, DC 20020Phone(202) 717-9238FaxUnlisted FaxMailing LocationMailing Address2041 Mlk Jr Ave SE, 234, Washington, DC 20020Phone(202) 717-9238FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted Issuer