Individual ProviderCrystal WebbNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2518 E Dupont Rd, Fort Wayne, IN 46825-1675(260) 432-4400PECOS EnrollmentBased on the most recent information from CMS, provider Crystal Webb 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 10:58 AM.Profile DetailsProvider ID1861935918Provider TypeIndividualFull NameWebb, CrystalGenderFemaleSole ProprietorNoEnumeration Date11/22/2016Last Updated12/8/2016Contact InformationPractice LocationPractice Address2518 E Dupont Rd, Fort Wayne, IN 46825-1675Phone(260) 432-4400Fax(260) 969-6898Mailing LocationMailing Address2518 E Dupont Rd, Fort Wayne, IN 46825-1675Phone(260) 432-4400Fax(260) 969-6898Provider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71006698AIndiana