Individual ProviderFelicia Anne ColclesserNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address5909 Illinois Rd, Fort Wayne, IN 46804-1159(260) 432-6026(260) 436-7255PECOS EnrollmentBased on the most recent information from CMS, provider Felicia Anne Colclesser 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 ID1932325644Provider TypeIndividualFull NameColclesser, Felicia AnneCredentialNPGenderFemaleSole ProprietorNoEnumeration Date4/18/2007Last Updated7/8/2007Contact InformationPractice LocationPractice Address5909 Illinois Rd, Fort Wayne, IN 46804-1159Phone(260) 432-6026FaxUnlisted FaxMailing LocationMailing Address4131 N Washington Rd, Fort Wayne, IN 46804-1821Phone(260) 436-7255FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicense71001217BIndiana