Individual ProviderCarolyn KellerPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address2105 Braxton Ln Ste 101, Greensboro, NC 27408-2862(336) 333-6306PECOS EnrollmentBased on the most recent information from CMS, provider Carolyn Keller 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 11:21 AM.Profile DetailsProvider ID1932704186Provider TypeIndividualFull NameKeller, CarolynCredentialPA-CGenderFemaleSole ProprietorNoEnumeration Date12/3/2020Last Updated5/2/2025Contact InformationPractice LocationPractice Address2105 Braxton Ln Ste 101, Greensboro, NC 27408-2862Phone(336) 333-6306Fax(336) 333-6309Mailing LocationMailing AddressPO Box 604345, Charlotte, NC 28260-4345PhoneUnlisted PhoneFaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363A00000XPrimaryDescriptionPhysician AssistantPhysician Assistants & Advanced Practice Nursing ProvidersLicense0010-10277North Carolina