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Jennelyn Velma Fraser-Johnson

Nurse Practitioner

Physician Assistants & Advanced Practice Nursing Providers

585 Schenectady Ave, Brooklyn, NY 11203-1822

PECOS Enrollment

This provider is enrolled in PECOS as JENNELYN FRASER-JOHNSON.

Based on the most recent information from CMS, provider Jennelyn Velma Fraser-Johnson 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 2 days ago.

Profile Details

Provider ID
1760535355
Provider Type
Individual
Full Name
Fraser-Johnson, Jennelyn Velma
Title
Ms.
Credential
F.N.P

Gender
Female
Sole Proprietor
No
Enumeration Date
1/19/2007
Last Updated
3/27/2009

Contact Information

Practice Location

585 Schenectady Ave, Brooklyn, NY 11203-1822

(718) 604-5397

(718) 604-5527

Mailing Location

585 Schenectady Ave, Brooklyn, NY 11203-1822

(718) 604-5397

(718) 604-5527

Provider Taxonomies

Code	Description	License
Code 363LF0000X Primary	Description Nurse Practitioner Physician Assistants & Advanced Practice Nursing Providers	License F333179 New York

Provider Identifiers

ID	Description	Issuer
ID F333179	Description Other	Issuer NYS NP LICENSE New York

Jennelyn Velma Fraser-Johnson

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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