Individual ProviderAbigail FlackNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6326 Constitution Dr, Fort Wayne, IN 46804-1518(260) 901-9601PECOS EnrollmentBased on the most recent information from CMS, provider Abigail Flack 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 yesterday at 12:57 PM.Profile DetailsProvider ID1093587420Provider TypeIndividualFull NameFlack, AbigailCredentialNPGenderFemaleSole ProprietorNoEnumeration Date10/30/2023Last Updated5/16/2025Contact InformationPractice LocationPractice Address6326 Constitution Dr, Fort Wayne, IN 46804-1518Phone(260) 901-9601FaxUnlisted FaxMailing LocationMailing Address6828 N 300 W, Roann, IN 46974-9669PhoneUnlisted PhoneFax(260) 201-9501Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71014421AIndiana