Individual ProviderKelsey Nicole BousemaRegistered NurseNursing Service ProvidersPractice Address815 E Pennsylvania Ave, Escondido, CA 92025-3424(760) 466-7020(209) 550-1982PECOS EnrollmentBased on the most recent information from CMS, provider Kelsey Nicole Bousema 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 yesterday at 12:57 PM.Profile DetailsProvider ID1851746846Provider TypeIndividualFull NameBousema, Kelsey NicoleTitleMrs.GenderFemaleSole ProprietorNoEnumeration Date4/27/2016Last Updated4/27/2016Contact InformationPractice LocationPractice Address815 E Pennsylvania Ave, Escondido, CA 92025-3424Phone(760) 466-7020FaxUnlisted FaxMailing LocationMailing Address1656 Warnock Dr, Ramona, CA 92065-3748Phone(209) 550-1982FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode163W00000XPrimaryDescriptionRegistered NurseNursing Service ProvidersLicense95031765California