Individual ProviderAthena Denice Evans-CampbellRegistered NurseNursing Service ProvidersPractice Address300 E Jefferson St Ste 101, Boise, ID 83712-6221(208) 388-7183(208) 954-1017PECOS EnrollmentBased on the most recent information from CMS, provider Athena Denice Evans-Campbell does not have current enrollment records in PECOS.Part BMedicare Part BNot EnrolledHHAHome Health AgencyNot EnrolledDMEDurable Medical EquipmentNot EnrolledPMDPower Mobility DeviceNot EnrolledCMS last updated its PECOS records 2 days ago.Profile DetailsProvider ID1841782083Provider TypeIndividualFull NameEvans-Campbell, Athena DeniceGenderFemaleSole ProprietorNoEnumeration Date6/4/2018Last Updated6/4/2018Contact InformationPractice LocationPractice Address300 E Jefferson St Ste 101, Boise, ID 83712-6221Phone(208) 388-7183FaxUnlisted FaxMailing LocationMailing Address1410 W Ranch Rd, Boise, ID 83702-1448Phone(208) 954-1017FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense21396Idaho