Individual ProviderKaitlyn BlaisNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2202 State Ave Ste 201, Panama City, FL 32405-4582(850) 785-0029(850) 851-9862PECOS EnrollmentBased on the most recent information from CMS, provider Kaitlyn Blais 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 ID1659987212Provider TypeIndividualFull NameBlais, KaitlynGenderFemaleSole ProprietorYesEnumeration Date9/18/2020Last Updated9/18/2020Contact InformationPractice LocationPractice Address2202 State Ave Ste 201, Panama City, FL 32405-4582Phone(850) 785-0029FaxUnlisted FaxMailing LocationMailing Address148 Rusty Gans Dr, Panama City, FL 32408-4510Phone(850) 851-9862FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense11009210Florida