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Taryn Donnell Kaiser

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133

PECOS Enrollment

This provider is enrolled in PECOS as TARYN KAISER.

Based on the most recent information from CMS, provider Taryn Donnell Kaiser 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 yesterday at 12:57 PM.

Profile Details

Provider ID
1740614247
Provider Type
Individual
Full Name
Kaiser, Taryn Donnell
Title
Mrs.
Credential
NP-C

Gender
Female
Sole Proprietor
No
Enumeration Date
9/3/2013
Last Updated
9/28/2016

Contact Information

Practice Location

7601 W Jefferson Blvd, Fort Wayne, IN 46804-4133

(260) 436-8686

(260) 436-8585

Mailing Location

PO Box 2526, Fort Wayne, IN 46801-2526

(260) 436-8686

(260) 436-8585

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License F0813041 Michigan

Provider Identifiers

ID	Description	Issuer
ID 201229350	Description Medicaid	Issuer Unlisted Indiana
ID 000001019560	Description Other	Issuer ANTHEM Indiana

Taryn Donnell Kaiser

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

ID

Description

Issuer

Mauger, Beverly Lynn

Wiedemann, Jessica A.

Royce, Hope E.

Lewton, Diane

Rp Care Llc

Adams-Hayes, Susan M

Pashova, Vivian

Stark, Kendra E.

Hermes, Tina J

Payton, Angela M.