Individual ProviderJill DusenberyCase Manager/Care CoordinatorOther Service ProvidersPractice Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610(505) 268-5295PECOS EnrollmentBased on the most recent information from CMS, provider Jill Dusenbery 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 12:57 PM.Profile DetailsProvider ID1437519360Provider TypeIndividualFull NameDusenbery, JillGenderFemaleSole ProprietorYesEnumeration Date3/4/2016Last Updated3/4/2016Contact InformationPractice LocationPractice Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610Phone(505) 268-5295FaxUnlisted FaxMailing LocationMailing Address5601 Domingo Rd NE, Albuquerque, NM 87108-1610Phone(505) 268-5295FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode171M00000XPrimaryDescriptionCase Manager/Care CoordinatorOther Service ProvidersLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerIDB9311DescriptionMedicaidIssuerUnlistedNew Mexico