Individual ProviderHanan KallashNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address10 E Wilson Blvd, Hagerstown, MD 21740-7331(410) 419-9184PECOS EnrollmentBased on the most recent information from CMS, provider Hanan Kallash is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1356735971Provider TypeIndividualFull NameKallash, HananCredentialFNPGenderFemaleSole ProprietorNoEnumeration Date3/20/2015Last Updated2/25/2026Contact InformationPractice LocationPractice Address10 E Wilson Blvd, Hagerstown, MD 21740-7331Phone(410) 419-9184FaxUnlisted FaxMailing LocationMailing Address118 Fiesta Dr, Stephenson, VA 22656-1876Phone(410) 419-9184FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LP0808XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024172402VirginiaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense0024172402VirginiaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseAC001498Maryland