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Michelle Lavette Bautista

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

508 Airport Rd Ste G, Panama City, FL 32405-4025

PECOS Enrollment

This provider is enrolled in PECOS as MICHELLE HINES-BAUTISTA.

Based on the most recent information from CMS, provider Michelle Lavette Bautista 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 2 days ago.

Profile Details

Provider ID
1326072398
Provider Type
Individual
Full Name
Bautista, Michelle Lavette
Credential
ARNP

Gender
Female
Sole Proprietor
Yes
Enumeration Date
7/10/2006
Last Updated
2/15/2023

Contact Information

Practice Location

508 Airport Rd Ste G, Panama City, FL 32405-4025

(850) 215-4455

(850) 215-4492

Mailing Location

PO Box 639, Panama City, FL 32402-0639

(850) 215-4455

(850) 215-4492

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License ARNP 2209302 Florida
Code 363LF0000X	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License AP137457 Texas

Michelle Lavette Bautista

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Code

Description

License

Ruder, Martha

Wester, Jordan

World, Shawntell

Pauley, Odie C

Eubanks, Melanie Ashleigh

Konen, Christie

Carmon, Mary Jansson

Jernigan, Sheryl A.

Boyd, Rachael

Gibbens, Brittany