Individual ProviderFelicia Nicole SmithNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address58 Hawthorne Dr, Hattiesburg, MS 39402-7232(662) 315-0755PECOS EnrollmentBased on the most recent information from CMS, provider Felicia Nicole Smith 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 5 days ago.Profile DetailsProvider ID1023616133Provider TypeIndividualFull NameSmith, Felicia NicoleTitleMissCredentialNPGenderFemaleSole ProprietorNoEnumeration Date10/12/2020Last Updated10/12/2020Contact InformationPractice LocationPractice Address58 Hawthorne Dr, Hattiesburg, MS 39402-7232Phone(662) 315-0755FaxUnlisted FaxMailing LocationMailing Address58 Hawthorne Dr, Hattiesburg, MS 39402-7232Phone(662) 315-0755FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense892288Mississippi