Individual ProviderLaury FarrellNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410(260) 260-5159(260) 609-4256PECOS EnrollmentBased on the most recent information from CMS, provider Laury Farrell 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 2 days ago.Profile DetailsProvider ID1891394599Provider TypeIndividualFull NameFarrell, LauryTitleMrs.CredentialFNPGenderFemaleSole ProprietorNoEnumeration Date10/22/2020Last Updated10/27/2020Contact InformationPractice LocationPractice Address6017 Stoney Creek Dr, Fort Wayne, IN 46825-4410Phone(260) 260-5159FaxUnlisted FaxMailing LocationMailing Address7160 S State Road 9, Columbia City, IN 46725-9659Phone(260) 609-4256FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363L00000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71010496AIndianaCode363LP2300XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71010496AIndiana