Individual ProviderMariechantal FletcherNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersPractice Address14300 Gallant Fox Ln Ste 202, Bowie, MD 20715-4033(301) 321-7741PECOS EnrollmentBased on the most recent information from CMS, provider Mariechantal Fletcher 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 9:43 AM.Profile DetailsProvider ID1992944847Provider TypeIndividualFull NameFletcher, MariechantalTitleDr.CredentialDNP FNP-BCGenderFemaleSole ProprietorNoEnumeration Date2/17/2009Last Updated11/7/2023Contact InformationPractice LocationPractice Address14300 Gallant Fox Ln Ste 202, Bowie, MD 20715-4033Phone(301) 321-7741Fax(301) 291-7071Mailing LocationMailing Address4500 Forbes Blvd Ste 430, Lanham, MD 20706-6301Phone(301) 321-7741FaxUnlisted FaxProvider TaxonomiesCodeDescriptionLicenseCode363LF0000XPrimaryDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR209991MarylandCode363LP0808XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseNP1031572District of ColumbiaCode363LF0000XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseNP1031572District of ColumbiaCode363LP0808XDescriptionNurse PractitionerPhysician Assistants & Advanced Practice Nursing ProvidersLicenseR209991MarylandProvider IdentifiersIDDescriptionIssuerID854305400DescriptionMedicaidIssuerUnlistedMarylandID010287032DescriptionMedicaidIssuerUnlistedDistrict of Columbia