Individual ProviderJacqueline BroomesNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address440 Lenox Rd Apt 5k, Brooklyn, NY 11203-2045(646) 247-7843PECOS EnrollmentBased on the most recent information from CMS, provider Jacqueline Broomes 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 ID1053037002Provider TypeIndividualFull NameBroomes, JacquelineCredentialNURSE PRACTITIONERGenderFemaleSole ProprietorYesEnumeration Date10/12/2022Last Updated10/12/2022Contact InformationPractice LocationPractice Address440 Lenox Rd Apt 5k, Brooklyn, NY 11203-2045Phone(646) 247-7843FaxUnlisted FaxMailing LocationMailing Address440 Lenox Rd Apt 5k, Brooklyn, NY 11203-2045Phone(646) 247-7843FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF348897New York