Look up the most recent NPI and PECOS records

Laurel Witte

Student in an Organized Health Care Education/Training Program

Student, Health Care

19555 N 59th Ave, Glendale, AZ 85308-6813

PECOS Enrollment

Based on the most recent information from CMS, provider Laurel Witte 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 6 days ago.

Profile Details

Provider ID
1417715996
Provider Type
Individual
Full Name
Witte, Laurel
Gender
Female

Sole Proprietor
No
Enumeration Date
3/11/2024
Last Updated
3/11/2024

Contact Information

Practice Location

19555 N 59th Ave, Glendale, AZ 85308-6813

(623) 572-3200

Unlisted Fax

Mailing Location

19555 N 59th Ave, Glendale, AZ 85308-6813

Unlisted Phone

Unlisted Fax

Provider Taxonomies

Code	Description	License
Code 390200000X Primary	Description Student in an Organized Health Care Education/Training Program Student, Health Care	License Unlisted Issuer

Laurel Witte

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Haong, Samantha

Edwards, Pamela (Pam) Ann

Wiertek, Marcellina

Han, Moe-Myint

Pfau, Ty

Meraz, Alexander Ian

Nasr, Chase D

Yanuszeski, Craig Vincent

Jandu, Reetika

Hanna, Candice Maria