Provider Demographics
NPI:1417036831
Name:FLUKE, MICHELE LEE (ARNP)
Entity Type:Individual
Prefix:MRS
First Name:MICHELE
Middle Name:LEE
Last Name:FLUKE
Suffix:
Gender:F
Credentials:ARNP
Other - Prefix:MS
Other - First Name:MICHELE
Other - Middle Name:LEE
Other - Last Name:SEWAR
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:NP-C
Mailing Address - Street 1:9635 SHAMOKIN LN
Mailing Address - Street 2:
Mailing Address - City:PORT RICHEY
Mailing Address - State:FL
Mailing Address - Zip Code:34668-3954
Mailing Address - Country:US
Mailing Address - Phone:727-841-7643
Mailing Address - Fax:
Practice Address - Street 1:11180 SPRING HILL DR
Practice Address - Street 2:
Practice Address - City:SPRING HILL
Practice Address - State:FL
Practice Address - Zip Code:34609-4648
Practice Address - Country:US
Practice Address - Phone:727-841-7643
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-11-05
Last Update Date:2017-11-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLARNP9191208363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily