Individual ProviderAbbegayle KisrowSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPractice Address2840 123rd Ave NW, Minneapolis, MN 55433-1727(612) 916-2627PECOS EnrollmentBased on the most recent information from CMS, provider Abbegayle Kisrow 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 yesterday at 9:15 AM.Profile DetailsProvider ID1225548126Provider TypeIndividualFull NameKisrow, AbbegayleGenderFemaleSole ProprietorYesEnumeration Date10/5/2017Last Updated10/5/2017Contact InformationPractice LocationPractice Address2840 123rd Ave NW, Minneapolis, MN 55433-1727Phone(612) 916-2627FaxUnlisted FaxMailing LocationMailing Address2840 123rd Ave NW, Minneapolis, MN 55433-1727Phone(612) 916-2627FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode2255A2300XPrimaryDescriptionSpecialist/TechnologistRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersLicenseUnlisted IssuerCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted Issuer