Individual ProviderJaneen L WalthallLicensed Practical NurseNursing Service ProvidersPractice Address2 Maler Ln, Patchogue, NY 11772-3558(631) 639-6713PECOS EnrollmentBased on the most recent information from CMS, provider Janeen L Walthall 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 2 days ago.Profile DetailsProvider ID1316210529Provider TypeIndividualFull NameWalthall, Janeen LGenderFemaleSole ProprietorYesEnumeration Date2/17/2012Last Updated2/17/2012Contact InformationPractice LocationPractice Address2 Maler Ln, Patchogue, NY 11772-3558Phone(631) 639-6713FaxUnlisted FaxMailing LocationMailing Address2 Maler Ln, Patchogue, NY 11772-3558Phone(631) 639-6713FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode164W00000XPrimaryDescriptionLicensed Practical NurseNursing Service ProvidersLicense306095New York