| Sean Ellis Mcmicken, NP | |
|
2200 Osprey Blvd, Bartow, FL 33830-3308 | |
| (800) 893-9698 | |
| Not Available |
| Full Name | Sean Ellis Mcmicken |
|---|---|
| Gender | Male |
| Speciality | Nurse Practitioner |
| Location | 2200 Osprey Blvd, Bartow, Florida |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598848327 | NPI | - | NPPES |
| 302720100 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | ARNP3170022 (Florida) | Primary |
| Entity Name | Polk Emergency Group Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1558338574 PECOS PAC ID: 0547241598 Enrollment ID: O20050506000658 |
| Mailing Address | Practice Location Address |
|---|---|
| Sean Ellis Mcmicken, NP 200 Corporate Blvd., Suite 201, Lafayette, LA 70508 Ph: (800) 893-9698 | Sean Ellis Mcmicken, NP 2200 Osprey Blvd, Bartow, FL 33830-3308 Ph: (800) 893-9698 |
Efrosini Xanthoudakis, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2200 Osprey Blvd, Bartow, FL 33830 Phone: 863-533-8111 | |
Jeena Mathew, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1170 Nevermore Cir, Bartow, FL 33830 Phone: 863-512-1055 | |
Sarah Anne Crowley, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1260 Golfview Ave, Bartow, FL 33830 Phone: 863-519-3900 | |
Ms. Patricia Clark, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1255 Golfview Ave, Bartow, FL 33830 Phone: 863-519-3750 Fax: 863-519-3753 | |
Yesenia Maria Martin, PMHNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1255 Golfview Ave, Bartow, FL 33830 Phone: 863-519-0575 Fax: 863-500-3776 | |
Sandra Kay Heisler, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1260 Golfview Ave, Bartow, FL 33830 Phone: 863-519-3900 | |
Lois Hall, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1255 Brice Blvd, Bartow, FL 33830 Phone: 863-519-7900 |