Individual ProviderAndrea Riels- BraswellNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address5001 Hardy St, Hattiesburg, MS 39402-1308(601) 296-2090PECOS EnrollmentBased on the most recent information from CMS, provider Andrea Riels- Braswell 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 5 days ago.Profile DetailsProvider ID1205184447Provider TypeIndividualFull NameRiels- Braswell, AndreaCredentialNPGenderFemaleSole ProprietorNoEnumeration Date8/20/2012Last Updated2/26/2018Contact InformationPractice LocationPractice Address5001 Hardy St, Hattiesburg, MS 39402-1308Phone(601) 296-2090Fax(601) 296-2089Mailing LocationMailing Address5001 Hardy St, Hattiesburg, MS 39402-1308Phone(601) 296-2090Fax(601) 296-2089Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR871722Mississippi