Individual ProviderJacquanna ThompsonRegistered NurseNursing Service ProvidersPractice Address2052 Tillotson Ave, Bronx, NY 10475-1560(718) 671-2100PECOS EnrollmentBased on the most recent information from CMS, provider Jacquanna Thompson 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 9:43 AM.Profile DetailsProvider ID1265805345Provider TypeIndividualFull NameThompson, JacquannaGenderFemaleSole ProprietorYesEnumeration Date11/11/2015Last Updated11/11/2015Contact InformationPractice LocationPractice Address2052 Tillotson Ave, Bronx, NY 10475-1560Phone(718) 671-2100FaxUnlisted FaxMailing LocationMailing Address2052 Tillotson Ave, Bronx, NY 10475-1560PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense685093New York