Individual ProviderJohanne JasminNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2015 Grand Concourse, Bronx, NY 10453-4303(718) 299-7295(718) 618-0401PECOS EnrollmentBased on the most recent information from CMS, provider Johanne Jasmin 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 3 days ago.Profile DetailsProvider ID1063032472Provider TypeIndividualFull NameJasmin, JohanneCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date4/26/2020Last Updated8/24/2020Contact InformationPractice LocationPractice Address2015 Grand Concourse, Bronx, NY 10453-4303Phone(718) 299-7295Fax(718) 299-6797Mailing LocationMailing Address1434 Williamsbridge Rd, Bronx, NY 10461-2507Phone(718) 618-0401Fax(347) 479-1303Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseF345177New York