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Odie C Pauley

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

2100 Harrison Ave, Panama City, FL 32405-4546

PECOS Enrollment

This provider is enrolled in PECOS as ODIE PAULEY.

Based on the most recent information from CMS, provider Odie C Pauley is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.

Part B
Medicare Part B
Enrolled
HHA
Home Health Agency
Enrolled
DME
Durable Medical Equipment
Enrolled
PMD
Power Mobility Device
Enrolled

CMS last updated its PECOS records 3 days ago.

Profile Details

Provider ID
1235822495
Provider Type
Individual
Full Name
Pauley, Odie C
Title
Mr.
Credential
APRN

Gender
Male
Sole Proprietor
No
Enumeration Date
6/1/2023
Last Updated
6/1/2023

Contact Information

Practice Location

2100 Harrison Ave, Panama City, FL 32405-4546

(850) 260-6566

Unlisted Fax

Mailing Location

1076 Ten Mile Rd, Bonifay, FL 32425-3577

(850) 260-6566

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License 11026660 Florida

Odie C Pauley

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Konen, Christie

Pauley, Kala

World, Shawntell

Brooks, Ashli A

Gibbens, Brittany

Gemsch, Linda Jolene

Roberts, Doris M

Smith, Katie L

Brown, Heather Richelle

Gibbens Family Medical Llc