Individual ProviderMichele Grace MackeyLicensed Practical NurseNursing Service ProvidersPractice Address849 Taylor Ave, East Patchogue, NY 11772-5057(631) 475-3206PECOS EnrollmentBased on the most recent information from CMS, provider Michele Grace Mackey 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 ID1114194974Provider TypeIndividualFull NameMackey, Michele GraceTitleMrs.CredentialLPNGenderFemaleSole ProprietorYesEnumeration Date5/12/2008Last Updated5/12/2008Contact InformationPractice LocationPractice Address849 Taylor Ave, East Patchogue, NY 11772-5057Phone(631) 475-3206FaxUnlisted FaxMailing LocationMailing Address849 Taylor Ave, East Patchogue, NY 11772-5057Phone(631) 475-3206FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense278210New YorkProvider IdentifiersIDDescriptionIssuerID278210DescriptionOtherIssuerNYS LICENSED PRACTICAL NURSING LICENSENew York