Individual ProviderPaige KelleyNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address3343 W Central Ave, Wichita, KS 67203-4917(316) 260-4110PECOS EnrollmentBased on the most recent information from CMS, provider Paige Kelley 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 ID1205627759Provider TypeIndividualFull NameKelley, PaigeGenderFemaleSole ProprietorNoEnumeration Date5/14/2025Last Updated5/14/2025Contact InformationPractice LocationPractice Address3343 W Central Ave, Wichita, KS 67203-4917Phone(316) 260-4110FaxUnlisted FaxMailing LocationMailing Address3343 W Central Ave, Wichita, KS 67203-4917Phone(316) 260-4110FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense53-84297-122Kansas