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Kevin C Clearman

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

110 Millsaps Dr, Hattiesburg, MS 39402-1347

PECOS Enrollment

This provider is enrolled in PECOS as KEVIN CLEARMAN.

Based on the most recent information from CMS, provider Kevin C Clearman 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 5 days ago.

Profile Details

Provider ID
1477557098
Provider Type
Individual
Full Name
Clearman, Kevin C
Title
Mr.
Credential
CNFP

Gender
Male
Sole Proprietor
No
Enumeration Date
6/10/2005
Last Updated
11/16/2007

Contact Information

Practice Location

110 Millsaps Dr, Hattiesburg, MS 39402-1347

(601) 261-5710

(601) 268-5058

Mailing Location

110 Millsaps Dr, Hattiesburg, MS 39402-1347

(601) 261-5710

(601) 268-5058

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License R852021 Mississippi

Provider Identifiers

ID	Description	Issuer
ID 00122565	Description Medicaid	Issuer Unlisted Mississippi

Kevin C Clearman

PECOS Enrollment

Profile Details

Contact Information

Practice Location

Mailing Location

Provider Taxonomies

Code

Description

License

Code

Description

License

Provider Identifiers

ID

Description

Issuer

ID

Description

Issuer

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