Individual ProviderKristen WaughNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address4500 San Pablo Rd S, Jacksonville, FL 32224-1865(904) 953-2000PECOS EnrollmentBased on the most recent information from CMS, provider Kristen Waugh is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 8 days ago.Profile DetailsProvider ID1053663021Provider TypeIndividualFull NameWaugh, KristenCredentialARNPGenderFemaleSole ProprietorNoEnumeration Date10/15/2012Last Updated8/31/2020Contact InformationPractice LocationPractice Address4500 San Pablo Rd S, Jacksonville, FL 32224-1865Phone(904) 953-2000FaxUnlisted FaxMailing LocationMailing Address4500 San Pablo Rd S, Jacksonville, FL 32224-1865PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseARNP9277641Florida