| Tara Sue King, ACNP | |
|
433 Maribella Ct, St Augustine, FL 32086-7749 | |
| (484) 788-3387 | |
| Not Available |
| Full Name | Tara Sue King |
|---|---|
| Gender | Female |
| Speciality | Nurse Practitioner |
| Experience | 3 Years |
| Location | 433 Maribella Ct, St Augustine, Florida |
| Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1871275974 | NPI | - | NPPES |
| 119811000 | Medicaid | FL |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 363L00000X | Nurse Practitioner | 11026947 (Florida) | Secondary |
| 363LA2100X | Nurse Practitioner - Acute Care | 11026947 (Florida) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Baptist Medical Center Beaches | Jacksonville beach, FL | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Jacksonville Lung Clinic Llc | 4486900412 | 10 |
| Entity Name | Jacksonville Lung Clinic Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861991937 PECOS PAC ID: 4486900412 Enrollment ID: O20180705002822 |
| Mailing Address | Practice Location Address |
|---|---|
| Tara Sue King, ACNP Po Box 100288, Gainesville, FL 32610-0277 Ph: (352) 273-9079 | Tara Sue King, ACNP 433 Maribella Ct, St Augustine, FL 32086-7749 Ph: (484) 788-3387 |
Dr. Lilia Diaz Pino, PH.D., ARNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2703 N Ponce De Leon Blvd, St Augustine, FL 32084 Phone: 866-389-2727 | |
Mrs. Yvonne Derickson, ARNP, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 206 Ashourian Ave Ste 209, St Augustine, FL 32092 Phone: 904-800-7246 Fax: 904-299-4116 | |
Mrs. Kelly Auclair, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 316 Paseo Reyes Dr, St Augustine, FL 32095 Phone: 903-544-5800 Fax: 903-544-5800 | |
Kay Lewis Hood, AGACNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 105 Whitehall Dr, St Augustine, FL 32086 Phone: 904-800-7246 | |
Joann Fritsch, Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 130 Health Park Blvd, St Augustine, FL 32086 Phone: 904-826-3469 Fax: 904-808-4608 | |
Rachel Long, Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 2703 N Ponce De Leon Blvd, St Augustine, FL 32084 Phone: 352-373-2507 | |
Melissa Spies, AGNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 2867 N 9th St, St Augustine, FL 32084 Phone: 904-999-7631 |