Individual ProviderAutumn EngstromRegistered NurseNursing Service ProvidersPractice Address4212 N 16th St, Phoenix, AZ 85016-5319(602) 263-1200PECOS EnrollmentBased on the most recent information from CMS, provider Autumn Engstrom 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 2 days ago.Profile DetailsProvider ID1013315183Provider TypeIndividualFull NameEngstrom, AutumnGenderFemaleSole ProprietorNoEnumeration Date12/5/2014Last Updated12/5/2014Contact InformationPractice LocationPractice Address4212 N 16th St, Phoenix, AZ 85016-5319Phone(602) 263-1200FaxUnlisted FaxMailing LocationMailing AddressPO Box 31001-0698, Pasadena, CA 91110-0698Phone(602) 263-1200FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense122282Iowa