Provider Demographics
NPI:1699086892
Name:SEAY, MIKA D (APRN)
Entity type:Individual
Prefix:
First Name:MIKA
Middle Name:D
Last Name:SEAY
Suffix:
Gender:F
Credentials:APRN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2432
Mailing Address - Street 2:
Mailing Address - City:JORDAN
Mailing Address - State:AR
Mailing Address - Zip Code:72519-2432
Mailing Address - Country:US
Mailing Address - Phone:870-404-0388
Mailing Address - Fax:
Practice Address - Street 1:4188 HWY 177 SOUTH
Practice Address - Street 2:
Practice Address - City:JORDAN
Practice Address - State:AR
Practice Address - Zip Code:72519-2432
Practice Address - Country:US
Practice Address - Phone:870-404-0388
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-23
Last Update Date:2020-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA003424363LF0000X
OK116175363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
ARP00866368OtherRAILROAD MEDICARE
AR185062758Medicaid
AR5V663Medicare PIN