Sean Gregory Scully
Individual provider Active NPI Family Nurse Practitioner · Ewa, HI
NPI 1265400899 · NPPES record last updated Jun 4, 2020
Key facts
- NPI
- 1265400899
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 2565 (HI)
- Practice address
- 91-590 Farrington Highway #300
Ewa, HI 96707 - Phone
- (808) 674-0269
- NPI assigned
- Mar 9, 2006
- Sex
- Male
- Sole proprietor
- No
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No · DME: Yes · Home health: No · Power mobility devices: Yes · Hospice: No
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2565 | HI | MD | Family Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 2565 | HI | Yes |
Addresses
Primary practice location
91-590 Farrington Highway #300
Ewa, HI 96707
Mailing address
1245 Kuala St
Pearl City, HI 96782-3900
Phone (808) 784-2273
Other practice location 1
2070 N King St # A1
Honolulu, HI 96819-3481
Phone (808) 841-2273
Other providers in Ewa, HI
All providers in Ewa, HI · Family Nurse Practitioner in Hawaii
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 4, 2020. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.