Individual ProviderKatelyn D'HaenePhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address1280 E Campus Dr, Mt Pleasant, MI 48858-3803(517) 803-6285(248) 865-7444PECOS EnrollmentBased on the most recent information from CMS, provider Katelyn D'Haene 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 yesterday at 12:57 PM.Profile DetailsProvider ID1720556335Provider TypeIndividualFull NameD'Haene, KatelynCredentialPA-CGenderFemaleSole ProprietorYesEnumeration Date11/13/2018Last Updated9/7/2021Contact InformationPractice LocationPractice Address1280 E Campus Dr, Mt Pleasant, MI 48858-3803Phone(517) 803-6285FaxUnlisted FaxMailing LocationMailing Address7125 Orchard Lake Rd, Ste 100, West Bloomfield, MI 48322-3616Phone(248) 865-7444FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense5601009593MichiganCode363A00000XDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicenseUnlisted Issuer