Individual ProviderSelena ClearmanNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address7100 U S Highway 98 Ste 140, Hattiesburg, MS 39402(601) 261-5710PECOS EnrollmentBased on the most recent information from CMS, provider Selena Clearman 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 5 days ago.Profile DetailsProvider ID1518944560Provider TypeIndividualFull NameClearman, SelenaCredentialFNP-BCGenderFemaleSole ProprietorNoEnumeration Date12/29/2005Last Updated9/5/2018Contact InformationPractice LocationPractice Address7100 U S Highway 98 Ste 140, Hattiesburg, MS 39402Phone(601) 261-5710Fax(601) 268-5058Mailing LocationMailing Address7100 U S Highway 98 Ste 140, Hattiesburg, MS 39402-8557Phone(601) 261-5710Fax(601) 268-5058Provider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR852019MississippiProvider IdentifiersIDDescriptionIssuerID11552881DescriptionOtherIssuerCAQH ID NUMBERMississippiID7684480DescriptionOtherIssuerAETNAMississippiID00123556DescriptionMedicaidIssuerUnlistedMississippiIDP00718596DescriptionOtherIssuerRAILROAD MEDICAREMississippi